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RSV

Respiratory syncytial virus 

Cold, flu, and RSV season is here!

Respiratory infections are spreading in our schools and communities. COVID-19 is still with us. Respiratory syncytial virus (RSV) infections are on the rise. And we're just now entering flu season.

As these viruses spread, families and providers need to prepare.

Last year's cold and flu season was especially dangerous for vulnerable babies and families as we saw an unprecedented tripledemic of flu, COVID, and RSV. This year we have some promising new tools and interventions, including new vaccines for adults and new protective injections for infants.

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What's different this season?

After a busy RSV season last year, new strategies are available now to help prevent RSV infection in infants.

 

The FDA has approved a new RSV monoclonal antibody, nirsevimab, brand name Beyfortus™, which can provide protection from RSV infection or reduction in severity of RSV infection.

 

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The CDC has recommended this vaccine for all infants less than 8 months of age during their first RSV season. It also recommends this vaccine for infants up to 24 months with certain medical conditions including chronic lung and cardiac disease as well as immunodeficiency. 

See RSV Vaccination: What Parents Should Know

 

Nirsevimab, similar to Synagis™, does not trigger the infant’s immune system like a typical vaccine. Rather, it is an injection of lab-made antibodies that provides passive immunity by targeting a protein which allows the respiratory syncytial virus (RSV) to infect cells.

While Synagis™ lasts only 28 days, requiring monthly vaccination for optimum protection, nirsevimab lasts up to 5 months meaning infants should require only one dose if given during the RSV season.

From the AAPChildren who receive nirsevimab should not get palivizumab. However, if your child did not get all doses of palivizumab, they may be eligible for nirsevimab. Children who received palivizumab in their first season can get nirsevimab in their second season if they are eligible.

  

NEW If you're pregnant.

2023 -2024 is an exciting year! This is the first respiratory virus season where we have vaccines to protect babies from all three major respiratory viruses – COVID-19, RSV, and flu.

Pfizer’s new bivalent RSVpreF vaccine (Abrysvo) is the first respiratory syncytial virus (RSV) vaccine for pregnant people that protects both them and their newborn from severe RSV illness. 

The CDC recommends seasonal administration of one dose of RSV vaccine for pregnant people during weeks 32 through 36 of pregnancy.

 

See Frequently Asked Questions About RSVpreF (Abrysvo) Vaccine for Pregnant People

“This is another new tool we can use this fall and winter to help protect lives,” said CDC Director Dr. Mandy Cohen. “I encourage parents to talk to their doctors about how to protect their little ones against serious RSV illness, using either a vaccine given during pregnancy, or an RSV immunization given to your baby after birth.”

To prevent RSV-associated lower respiratory tract infections (LRTIs) in infants, the CDC recommends either:

 

  • administering RSVpreF (Abrysvo) vaccine during pregnancy

or

  • administering RSV monoclonal antibody, nirsevimab (Beyfortus™) to the infant after birth

NOTE: Most infants will not need protection from both products.

RSVpreF (Abrysvo™) should be administered during weeks 32 through 36 of pregnancy (i.e., 32 weeks 0 days through 36 weeks 6 days). In most of the continental United States, the vaccine should be administered from September through January.

In order to empower patients and promote shared decision-making, pregnant people and their providers should talk about the benefits of vaccination during pregnancy and the decision whether to get vaccinated now to provide immunity to their newborn or to give their baby protective antibody shots after they're born.

 

 

Things Pregnant People May Want to Consider:

  • The RSV vaccine gives your baby protection right after birth.

  • If you get the RSV vaccine, there is one less injection for your baby to get after birth.

  • Nirsevimab may provide your baby with longer-lasting protection.

  • It may be hard to get nirsevimab this fall and winter. Your ob-gyn may be able to help you find out if nirsevimab will be available for your baby after birth.

These fact sheets describe how to protect you and your baby from RSV infection.

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newest

In October the Centers for Disease Control and Prevention (CDC) is issued this Health Alert Network (HAN) Health Advisory to provide options for clinicians to protect infants from respiratory syncytial virus (RSV) in the context of a limited supply of nirsevimab. 

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RSV is a Troublemaker!

WATCH:  General pediatrician Lynn Smitherman, MD, explains how the burden of RSV weighs heavily on babies, children and their families.

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Recognizing RSV.

Respiratory Syncytial Virus (RSV) is one version of the common cold.
For most healthy children and adults it will cause a slight cough, watery nasal congestion, and mild fever. But for many infants - including babies who were born prematurely or have certain health conditions - RSV can be much more serious and have devastating health consequences.

  • Some babies who get infected with RSV are sick for weeks - and quickly develop bronchiolitis or pneumonia

  • They may wheeze for months - or even years - and can go on to develop chronic lung disease.

  • Because it clogs their airways, many babies cannot get enough oxygen and must be admitted to the hospital for respiratory support.

  • Hospital admissions can last a week or longer.

  • The sickest babies may even need to be placed on a breathing machine or heart lung bypass.

  • Tragically, some babies infected with RSV die from its effects.
     

It may be the common cold for you...
but it can be life-threatening for some babies.

We love these resources from Sobi, the makers of Synagis (palivizimab). 

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The Dangers of RSV

Neonatologist Vincent Smith, MD, explains why RSV can be dangerous for infants and young children.

What we can do.

We know that taking these steps will help us reduce the risks of respiratory infections:

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We love these resources from Sesame Street in Communities

Understanding RSV

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RSV is a really serious virus.

Spread the word - not the infection.

Share this video from the American Lung Association with people you care about.

How providers can help.

Providers can help reduce the burden of RSV infections in our communities by:

  • Knowing the signs and symptoms of severe respiratory infection

  • Tracking national data and trends at the CDC's website

  • Providing families and insurers with the information they need to access Synagis (palivizumab) protective therapies

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advocacy

Advocating for evidence-based care for vulnerable infants.


Babies who were born prematurely or who have compromised respiratory or immune systems may benefit from the monthly antibody injections of Synagis (palivizimab). When given as prophylaxis monthly during the RSV season these injections of monoclonal antibodies are an effective way to significantly decrease the risks of RSV infection for this vulnerable population. There is solid evidence that babies who were born prematurely or have compromised respiratory or immune systems benefit from these antibody injections.  


The National Perinatal Association

supports access to this much-needed therapy.

See our Evidence-Based Interdisciplinary Collaboration:

 

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The good news is that we have a proven, effective therapies and there are FDA-approved, evidence-based guidelines that describe which babies should have access to these medications. 

The FDA has approved a new RSV monoclonal antibody, nirsevimab, brand name Beyfortus, which can provide protection or reduction in severity of RSV infection. The CDC has recommended this vaccine for all infants less than 8 months of age during their first RSV season. NOTE: See this Health Alert Network (HAN) bulletin on Limited Availability of Nirsevimab in the United States - Interim CDC Recommendations to Protect Infants from Respiratory Syncytial Virus (RSV) during the 2023–2024 Respiratory Virus Season

See NPA's statement,

New Advances in the Prevention of RSV Infection.

 

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Currently the NPA supports several initiatives to address this issue, including the following:

  • The creation of resources for parents and professionals that highlight current information about RSV and how to appeal insurer's decisions to deny access to RSV prophylaxis for a child who is at high risk.

  • Partnering with organizations to collaborate on effective ways to educate and inform the public, healthcare providers, payers and policy makers about this issue.

 

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The Gap Baby: An RSV Story

Most young children encounter what’s known as Respiratory Syncytial Virus, or RSV, before age two. It’s a common seasonal virus with flu-like symptoms. But as this video from the National Coalition for Infant Health explains, premature infants whose health plans don’t cover preventive RSV treatment may suffer – and unnecessarily so.

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