# Why is RSV such a big deal these days?

**URL:** <https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909>\
**Category:** The Quarantine Zone\
**Tags:** covid-quarantine\
**Created:** [November 14, 2022, 8:34pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909 "2022-11-14T20:34:20Z")\
**Posts on this page:** 14\
**Page:** 3

<div class="post-metadata">

**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\
**Post date:** [January 17, 2024, 7:43am UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/41 "2024-01-17T07:43:57Z")

</div>

> [@Dr\_Paprika](#):
>
> Canadian protocols don’t tend to differ much from the US, but national variations are possible, including drug names

In this case the protocols aren’t what differ much but apparently what is approved.

“At present there is no vaccine available in Canada to prevent RSV.”?

Palivizumab, the monoclonal antibody discussed above (brand name Synagis) has been around for years and has fairly narrow indications.

The new one this year, in the States at least, is nirsevimab, (brand name Beyfortus), is less expensive, and has broader indications.

> **[Healthcare Providers: RSV Immunization for Children 19 Months and Younger | CDC](https://www.cdc.gov/vaccines/vpd/rsv/hcp/child.html)**
>
> Healthcare professionals, learn about RSV vaccination information for children 19 months and younger.

[Modifications](https://emergency.cdc.gov/han/2023/han00499.asp) to the guidelines made in face of limited availability.

---

<div class="post-metadata">

**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\
**Post date:** [January 17, 2024, 12:28pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/42 "2024-01-17T12:28:16Z")

</div>

Beyfortus has been recently approved in Canada, for the indications you mention. Hopefully it helps keep people out of hospital. I gather guidelines and increasing availability are works in progress.

---

<div class="post-metadata">

**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\
**Post date:** [January 17, 2024, 1:15pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/43 "2024-01-17T13:15:28Z")

</div>

Doubling back to the adult vaccines: it must be noted that the guidance for adults over 60 is on the “may” scale, not the “should” level. It’s a “discuss the choice with your doctor” guidance.

The incidence of RSV associated hospitalization among the 60 to 84 group is still quite [low](https://pneumonia.biomedcentral.com/articles/10.1186/s41479-022-00098-x#:~:text=The%20highest%20estimated%20annual%20incidence,%2C%2095%25%20CrI%20%5B680%2C). Strongest advice to do it is for those with comorbid conditions that might result in a weakened immune system. The data to date showed significant reductions from hospitalization in season one, less significant in season two, and no time yet for longer results in seasons beyond that. It may end up not as a one and done; I’d be surprised if it does.

I’d rank regular flu shots as a much higher priority.

---

<div class="post-metadata">

**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\
**Post date:** [January 17, 2024, 1:57pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/44 "2024-01-17T13:57:54Z")

</div>

It seems there are now three distinct lines of RSV vaccines: **[Nirsevimab - Wikipedia](https://en.wikipedia.org/wiki/Nirsevimab)** and **[Palivizumab - Wikipedia](https://en.wikipedia.org/wiki/Palivizumab)** already mentioned by the docs upthread.

Plus something different and recently approved in the USA whose proper chemical name I can’t come up with but which are sold in the USA under the trade names Arexvy and Abrysvo by different manufacturers. **[Respiratory syncytial virus vaccine - Wikipedia](https://en.wikipedia.org/wiki/Respiratory_syncytial_virus_vaccine#History)**.

Some of the difference might be pediatric vs adult use. I ended up with the Abrysvo.

---

<div class="post-metadata">

**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\
**Post date:** [January 17, 2024, 2:55pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/45 "2024-01-17T14:55:39Z")

</div>

The first two are not actually _vaccines_; they are monoclonal antibodies which provide passive protection. Beyfortus the newer.

The second two, approved for adults, are vaccines triggering an active response by the body. Given to pregnant women the response they cause results in antibodies transferring to the fetus providing protection to the newborn for the season.

---

<div class="post-metadata">

**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\
**Post date:** [January 17, 2024, 3:05pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/46 "2024-01-17T15:05:01Z")

</div>

Thank you. I was struggling to figure out a useful taxonomy.

---

<div class="post-metadata">

**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\
**Post date:** [January 18, 2024, 4:54am UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/47 "2024-01-18T04:54:35Z")

</div>

> [@Ulf\_the\_Unwashed](#):
>
> I know this because our newborn son acquired it from me. … In contrast, the little guy stopped breathing, had to be rushed to the NICU or the moral equivalent, and was housed in an incubator for about 5 days. He was just three weeks old.
> 
> It was probably the scariest time of my life, and I would strongly urge anyone on the fence about whether to get the vaccine to consider this story.
> 
> My son recovered just fine and is now a happy healthy 35-year-old, but wow, this disease can be REALLY HORRIBLE for infants.

YIKES!!!

My daughter likely had RSV at about 9 months old - really, really wretched “cold” where we had to get a nebulizer for her at home. They did not routinely test for RSV, and luckily she did not decline to the point of needing a trip to the hospital. She She was born 6 weeks early and spent a few days on a ventilator, so anything respiratory made me very, very twitchy on her behalf.

She did develop (intermittent) asthma later on. There’s a correlation between RSV as a young child and asthma later - but it’s not clear to me whether the RSV predisposes you, or the asthmatic tendency lets the RSV hit harder so it gets noticed.

---

<div class="post-metadata">

**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\
**Post date:** [January 18, 2024, 7:53am UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/48 "2024-01-18T07:53:40Z")

</div>

> [@Mama\_Zappa](#):
>
> it’s not clear to me whether the RSV predisposes you, or the asthmatic tendency lets the RSV hit harder so it gets noticed.

A very important question that still does not have a definitive answer!

The correlation is clear. Getting more severe clinical disease to RSV correlates with future recurrent wheeze and later asthma diagnosis. But is it a marker and result of that predisposition or does it damage the lungs and cause the disposition… or both to some degree.

I’ve long been of the _belief_ that is it more a marker of the risk, but if it does indeed also cause future risk then the new approach of vaccination during pregnancy and monoclonal antibody administration during infancy will do more than prevent severe bronchiolitis; it will also reduce future asthma burden.

---

<div class="post-metadata">

**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\
**Post date:** [January 21, 2024, 7:34pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/49 "2024-01-21T19:34:36Z")

</div>

> [@DSeid](#):
>
> it will also reduce future asthma burden.

That would certainly be fantastic!!

Moon Unit is lucky in that her asthma seems very, very intermittent; she hasn’t needed treatment for it in years, and was never in need of a maintenance inhaler. So, despite the prematurity, ventilation in the NICU, and the (likely) RSV, she seems to have gotten off very lightly. As a lifelong asthmatic, the idea of avoiding all the risks associated with asthma is very, very pleasing.

---

<div class="post-metadata">

**Author:** ![teelabrown](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/teelabrown/32/8412_2.png) [@teelabrown](https://boards.straightdope.com/u/teelabrown)\
**Post date:** [March 20, 2024, 7:41pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/50 "2024-03-20T19:41:48Z")

</div>

I’m 67, and I got the RSV vaxx yesterday. It was a painful one for me, at least compared to Covid boosters, which I can hardly even feel.

Today the side effects hit me pretty hard. I had aches, pains, chills, fever, nausea and diarrhea all morning long. I’m just now feeling half-human and am nibbling on some cereal. At least it’s one and done for this one.

---

<div class="post-metadata">

**Author:** ![hajario](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hajario/32/171_2.png) [@hajario](https://boards.straightdope.com/u/hajario)\
**Post date:** [March 20, 2024, 8:31pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/51 "2024-03-20T20:31:57Z")

</div>

The RSV was a killer. It took me out for a couple days

---

<div class="post-metadata">

**Author:** ![JohnGalt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johngalt/32/184_2.png) [@JohnGalt](https://boards.straightdope.com/u/JohnGalt)\
**Post date:** [March 20, 2024, 8:53pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/52 "2024-03-20T20:53:19Z")

</div>

I’m 66 and also got the RSV vaccination yesterday. I’ve never had any complications from the previous COVID vaccinations, and so far besides some injection site soreness, no reactions from the RSV shot. It’s about as painful as a shingles shot was for me. (I hope I’m not jinxing myself…)

---

<div class="post-metadata">

**Author:** ![hajario](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hajario/32/171_2.png) [@hajario](https://boards.straightdope.com/u/hajario)\
**Post date:** [March 20, 2024, 8:56pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/53 "2024-03-20T20:56:46Z")

</div>

I turned 60 in December. I wanted to get it the day after my birthday because it was a convenient time. The CVS website wouldn’t let me schedule it until I was 60 even if the shot was for after my birthday. I ended up getting it a couple of days after that.

---

<div class="post-metadata">

**Author:** ![LSLGuy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lslguy/32/5813_2.png) [@LSLGuy](https://boards.straightdope.com/u/LSLGuy)\
**Post date:** [March 20, 2024, 9:13pm UTC](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909/54 "2024-03-20T21:13:07Z")

</div>

My noes from my RSV shot !6 months ago say no unusual discomfort going in, and no subsequent reaction.

[Previous page](https://boards.straightdope.com/t/why-is-rsv-such-a-big-deal-these-days/974909.md?page=2)
