You Get a Booster, You Get a Booster – Fall 2023 Vaccine Updates 

There have been some new developments in the area of vaccine-preventable illnesses. Earlier this year, the U.S. Food and Drug Administration (FDA) approved two vaccines to protect against respiratory syncytial virus (RSV). Abrexvy (manufacturer GlaxoSmithKline) and Abrysvo (manufacturer Pfizer) are now available on the market to prevent RSV, but some people may be wondering, what is the point of another vaccine, and should I get it?

RSV is a respiratory infection that causes symptoms similar to a cold, including runny nose, decreased appetite, coughing, sneezing, fever, and wheezing.¹ It is spread through contact with respiratory droplets from the coughs or sneezes of someone infected with the virus, or from touching surfaces contaminated with the virus and then touching your face.¹ Similar to influenza or COVID-19, RSV can also progress and lead to severe illness, hospitalization, and death, particularly in the very young and elderly.^1,2  There has been growing National attention to develop a vaccine to protect against RSV due to the increase in infection rates seen during the 2022-2023 RSV season.² The current recommendation from the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) is that anyone 60 years of age or older is eligible to receive the RSV vaccine with what they call “shared clinical decision making.”³ This means that if you are interested in the vaccine and are 60 or older, it is recommended that you talk with your doctor to jointly decide if the vaccine is necessary. Adults who are more likely to become severely ill from an RSV infection are those with COPD, asthma, heart failure, kidney disease, or who are immunocompromised, so these populations will likely have greater benefit from receiving the vaccine.³ 

Data from the RSV vaccine trials are promising, with relatively high effectiveness (> 80%) in preventing RSV symptoms.^3,4,5 These vaccines also seem to be well-tolerated with low rates of side effects, the most common being soreness around the injection site.^4,5 The available RSV vaccines are administered as a single dose.RSV season starts in October, and it is recommended that vaccination occur before RSV season for the best coverage.³ The RSV vaccine can be given with the COVID-19 booster or flu vaccine at the same time.³ As previously mentioned, infants are at a high risk for contracting RSV and becoming hospitalized. At the time of writing this article, there is no recommendation from the CDC for pregnant women to receive the vaccine to protect newborns. If pregnant, it is best to talk with your physician or OB-GYN so potential benefits and risks can be evaluated, and a shared clinical decision can be made. 

Moving on from RSV, the annual influenza (flu) vaccine is now available for anyone 6 months of age or older. There are few limitations that would prevent someone from receiving the flu vaccine. Even those with a history of an egg allergy can receive a flu vaccine. There are no new updates to the flu vaccine recommendations from the CDC, as this vaccine is highly safe and effective at prevention severe illness, hospitalizations, and death from the influenza virus each year.⁶ Talk to your doctor if you have any questions on if the flu vaccine is right for you.

COVID-19 booster shots will be available soon. This new vaccine will target the most common subvariants that are causing illness. A one-time booster shot is recommended for most people to stay up to date.⁷  If you are 65 years of age or older, are immunocompromised, or caring for a child that is under 6 years old, the recommendations on booster shot eligibility can be found here: Stay Up to Date with COVID-19 Vaccines | CDC. COVID-19 booster shots are likely going to be an annual vaccine, just like the flu vaccine. Drug manufacturers are working on a combined flu shot and COVID-19 booster in one syringe to limit the need for multiple injections each year in those who are interested in multiple vaccines. 

If you have questions on which vaccines you are eligible for, talk with your physician or pharmacist to learn more!

References:

1. Respiratory syncytial virus – symptoms and care. Centers for Disease Control and Prevention. Symptoms and Care of RSV (Respiratory Syncytial Virus) | CDC. Updated August 16, 2023. Accessed September 4, 2023. 
2. McLaughlin JM, et al. Rates of medically attended RSV among US adults: a systematic review and meta-analysis. Open Forum Infectious Disease. 2022;9(7).  
3. Melgar M, et al. Use of respiratory syncytial virus vaccines in older adults: recommendations of the Advisory Committee on Immunization Practices – United States, 2023. Centers for Disease Control and Prevention MMWR. 2023;72(29):793-801.  
4. Walsh EE, et al. Efficacy and safety of a bivalent RSV prefusion F vaccine in older adults. N Eng J Med. 2023;338:1465-1477. DOI: 10.1056/NEJMoa2213836. 
5. Papi A, et al. Respiratory syncytial virus prefusion F protein vaccine in older adults. N Eng J Med. 2023;388:595-608. DOI: 10.1056/NEJMoa2209604. 
6. Influenza. Centers for Disease Control and Prevention. Seasonal Flu Vaccines | CDC. Updated August 25, 2023. Accessed September 4, 2023. 
7. Stay up to date with vaccines. Stay Up to Date with COVID-19 Vaccines | CDC. Updated July 17, 2023. Accessed September 4, 2023.