RSV Vaccines in COPD: Should I Get The New Vaccine?

What Is RSV?

RSV is an abbreviation for Respiratory Syncthial Virus – a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization.

Respiratory syncytial virus (RSV) in cross-section landing on the surface of a human cell lining the breathing tubes

People infected with RSV usually show symptoms within 4 to 6 days after getting infected. Symptoms of RSV infection usually include:

• Runny nose

• Decrease in appetite

• Coughing

• Sneezing

• Fever

• Wheezing

RSV can cause more severe infections such as bronchiolitis, an inflammation of the small airways in the lung, and pneumonia.'

How Does RSV Spread?

• An infected person coughs or sneezes

• You get virus droplets from a cough or sneeze in your eyes, nose, or mouth

• You have direct contact with the virus, like kissing the face of a child with RSV

• You touch a surface that has the virus on it, like a doorknob, and then touch your face before washing your hands

• Transmission is the same as with other respiratory viruses such as flu and COVID.

People infected with RSV are usually contagious for 3 to 8 days and may become contagious a day or two before they start showing signs of illness. However, some infants, and people with weakened immune systems, can continue to spread the virus even after they stop showing symptoms, for as long as 4 weeks. Children are often exposed to and infected with RSV outside the home, such as in school or childcare centers. They can then transmit the virus to other members of the family.

Who Gets RSV?

People are typically infected with RSV for the first time as an infant or toddler and nearly all children are infected before their second birthday. However, people of any age can be infected. Infections in healthy children and adults are generally less severe than among infants and older adults with certain medical conditions.

Adults at highest risk for severe disease include those with a compromised immune system and those with heart or lung disease including asthma and COPD.  Certainly, a RSV infection can cause a flare-up, or exacerbation, of COPD.

Is There Treatment For An RSV Infection? There is no specific antibiotic that treats RSV. Treatment is supportive including intravenous fluids, oxygen if necessary, suctioning of mucus, and a breathing tube (mechanical ventilation) if necessary. Thus, the best way to protect yourself is vaccination.

Standard vaccination procedure

What Are The Vaccines For RSV?

In June 2023, the CDC recommended RSV vaccination for adults 60 or older based on a discussion with your healthcare professional about whether RSV vaccination is right for you. There are currently two approved RSV vaccines for adults 60 years of age and older that will be available this fall. One is called Arevxy made by GlaxoSmithKline, and the other is called Abrysvo made by Pfizer. The Arevxy vaccine contains an adjuvant which enhances the immune response; it is the same adjuvant used in the recombivant zoster vaccine (Shingrix) to prevent shingles.

Both vaccines are approved as a single dose. In clinical studies the vaccines were more than 80% effective in preventing RSV infection in the first winter season after vaccination.

What Are The Side Effects Of The RSV vaccines?

The most common side effects reported in the studies were pain, redness, and swelling where the shot was given, fatigue, fever, headache, nausea, and muscle and joint pain. Generally, these side effects were quite mild and similar to possible side effects of the flu (influenza) vaccine.

When Should I Get The Vaccine If I Decide To Receive It?

Ideally, vaccination should occur before the start of fall and winter RSV season.

RSV Vaccines In COPD. I encourage you to discuss getting the RSV vaccine with your primary care and/or pulmonary specialist. It is clear from the recent COVID-19 pandemic that some individuals want to do everything possible to protect themselves, while others are cautious about getting a,new vaccine.

Can I Get The RSV Vaccine With Other Adult Vaccines?

The CDC states that it is acceptable to get the RSV vaccine at the same time as the influenza (flu) vaccine. However, it is important to understand that side effects may be increased when these two vaccines are given at the same time.

For patients with COPD in my practice, I recommend receiving only one vaccine at a time to minimize the risk of increased side effects. Ideally, you wait 1 – 2 weeks between vaccinations if this is convenient for you and your health care professional.