RSV Vaccines for Pregnant Individuals and Infants: Ensuring Informed Decision-Making

The recent guidelines issued by the Centers for Disease Control and Prevention (CDC) pertaining to RSV vaccines have garnered significant attention, shedding light on the criticality of safeguarding newborns and infants against respiratory syncytial virus (RSV). The advent of novel vaccines has revolutionized the realm of RSV prevention. The objective of this article is to offer lucidity on the eligible recipients and optimal timing for administering these vaccines, while also presenting pertinent factors for parents and caregivers to contemplate.

The Centers for Disease Control and Prevention (CDC) now recommends the administration of a maternal respiratory syncytial virus (RSV) vaccine to pregnant individuals between 32 and 36 weeks gestation during the RSV season. This vaccine, known as Abrysvo and developed by Pfizer, has shown a significant decrease in the likelihood of RSV hospitalization for infants, with a reduction of up to 57% during the first six months after birth. The rationale behind this recommendation is to allow sufficient time for the development of antibodies in the pregnant individual, which can then be transferred to the infant through the placenta, providing protection upon birth.

In August, the Advisory Committee on Immunization Practices endorsed the use of a monoclonal antibody called Beyfortus, produced by Sanofi and AstraZeneca, to protect infants from the severe outcomes associated with RSV. This antibody can be administered to infants under 8 months old who are entering their first RSV season, as well as to children aged 8 to 19 months who are at a higher risk of experiencing severe disease during their second season. This new drug functions similarly to a vaccine and has demonstrated a remarkable reduction in RSV hospitalizations and healthcare visits among infants, with an approximate 80% decrease, according to the CDC.

The timing of administration is of utmost importance for optimal protection. It is imperative to administer the maternal RSV vaccine and the infant shot during the RSV season, which typically occurs from September to January in most regions of the United States. Administering the vaccine to pregnant individuals outside of this timeframe may not yield the desired effectiveness, as their immunity may diminish by the time RSV cases surge. However, it is worth noting that the COVID-19 pandemic has disrupted the seasonality of certain respiratory illnesses, including RSV and influenza. Occasional outbreaks have occurred outside the usual season due to increased travel. While these diseases are likely to remain seasonal, monitoring RSV cases during this period will provide valuable insights for future strategies.

When it comes to selecting the appropriate vaccine, most infants will require either the maternal RSV vaccine or the infant shot after birth, but not both. However, exceptions may arise when a baby is born less than two weeks after the maternal vaccination. In such cases, there may not have been sufficient time for the pregnant individual to develop antibodies for transfer. In such instances, doctors may recommend the monoclonal antibody shot for the baby. Furthermore, Beyfortus is a suitable option for children aged 8 to 19 months in their second RSV season if they are at an elevated risk of severe disease.

At present, there is a lack of comparative data regarding the two different RSV vaccines, which poses a challenge in determining the superior choice. It is expected that more clarity on this matter will be achieved after several RSV seasons. In the meantime, individuals can make well-informed decisions based on eligibility, personal preferences, and guidance from healthcare professionals.

In conclusion, the introduction of maternal and infant RSV vaccines represents a significant advancement in safeguarding vulnerable infants against RSV-related illnesses. By understanding the eligibility criteria and engaging in discussions about vaccination options with healthcare providers, parents and caregivers will be empowered to make the most suitable choices for their children's health. Although further research is necessary to establish the optimal vaccine, the current options provide hope for a healthier and safer future for our young ones.