Guest Post By Genevieve Kane, MSN, RN
If there is one unifying sentiment among parents and caregivers of children this year, it’s that it has been an incredibly rough year for pediatric illnesses. Kids have caught bug after bug, and children’s hospitals are struggling to keep up with the demand.
One disease making the rounds (alongside strep throat, COVID, influenza, and all the others) is respiratory syncytial virus, or RSV. RSV is known to cause severe respiratory illness in young kids. There are currently vaccines in development to prevent RSV.
Until we reach that point, here’s what you need to know about RSV vaccine development and the RSV shot given to premature infants and those with other underlying medical conditions.
RSV Vaccine Vs. RSV Shot
There is currently no vaccine available to prevent RSV. However, per the Centers for Disease Control and Prevention (CDC), vaccine development is underway. Pfizer is the company behind one of the vaccines undergoing trials. They have a vaccine for RSV that is currently in the third phase of vaccine trials. This vaccine has been tested in pregnant individuals (as well as older adults).
They hope to submit their vaccine for approval by the end of the year. The vaccine would be administered to pregnant individuals toward the end of their pregnancy (between weeks 28-36) to provide immune support to the developing infant through the mother. Dr. Goudy speaks to this exciting development and shares the hope that this vaccine will prevent severe RSV seasons in the future.
While there is no RSV vaccine yet, infants and young children with various risk factors may be eligible for a shot to reduce the risk of RSV. Per the manufacturer's website, this shot is a medication, not a vaccine. It’s known by the brand name SYNAGIS and is the medication palivizumab.
What the RSV Shot Is and How It Works
SYNAGIS is a medication given by injection that contains manufactured antibodies against RSV. SYNAGIS helps prevent severe disease from RSV in infants and those under two years old with various risk factors. While this sounds similar to a vaccine, SYNAGIS is technically in a class of medications known as monoclonal antibodies.
Here are the main differences between vaccines and monoclonal antibodies, per AstraZeneca.
- A weakened part of a virus or other pathogen that is given to initiate an immune response.
- It can take weeks to develop an immune response after vaccination.
- The goal is long-term protection.
- Molecules that mimic an antibody response in the body to prevent an infection.
- They can work almost immediately.
- How long they work can vary, and protection may be short-lived.
Per the manufacturer, SYNAGIS is typically given every 28-30 days (so about once a month) during RSV season, up to five doses. However, the 2022-2023 RSV season is more severe than most and does not follow the typical late fall and early spring disease pattern.
Due to the increased severity and length of RSV season this year, the American Academy of Pediatrics (AAP) has put into effect interim guidelines that recommend at risk infants and young children can receive more than five doses of SYNAGIS, as needed.
Who Gets the RSV Shot?
SYNAGIS is approved for infants born prematurely, at or before 35 weeks of age, and who are six months or younger at the beginning of RSV season. Other criteria include children under two years old with certain lung and heart conditions that make them at risk of more severe disease if they catch RSV.
While the above criteria are who the medication is approved for, the AAP provides slightly different recommendations. Per the AAP, their recommendations are:
- Infants born before 29 weeks and who are younger than 12 months old at the start of RSV season.
- Infants born at 29 weeks or later with congenital lung or heart disease or other conditions that place them at higher risk of severe disease.
- Infants born at less than 32 weeks and who required certain levels of oxygen for 28 days or longer.
- Children younger than two years old with congenital lung or heart conditions that required various levels of medical support in the six months preceding RSV season.
- Children 12 months and younger with various types of congenital heart disease.
- Children under two who have other health conditions or risk factors, in consultation with a medical provider.
The medication’s effectiveness in preventing severe disease and hospitalizations and the cost of the drug form the basis for the AAP’s recommendations. SYNAGIS is expensive, with the two doses (50mg and 100mg) costing $1628.28 for 50 mg and $3074.65 for 100 mg, per the SYNAGIS pricing webpage.
Quick Tips if Your Child Does Catch RSV
If your child does catch RSV this season, it’s important to consider what you can do at home to help your little one feel comfortable. It’s also important to understand when you need help from a healthcare provider.
Nemours KidsHealth provides excellent tips for home care for RSV. They include:
- Help your child be as comfortable as possible (this is the time to snuggle your little one as much as they want).
- Allow your child plenty of time to rest.
- Encourage fluids, especially in small amounts, often.
- Treat fevers as appropriate based on your child’s weight and age.
- Consider using a cool-mist humidifier. Just make sure to clean it every day.
- And, if your little one is too young to blow their nose, consider using a nasal bulb or nasal aspirator like the NozeBot. Nasal aspiration can make it easier for a baby to breathe, eat, and drink.
One of the biggest concerns with RSV is its impact on a baby’s or child’s ability to breathe. Per Nemours KidsHealth, it’s time to seek medical care if you notice your child:
- Struggling to breathe
- Having trouble catching their breath
- Has lips tinged blue or purple or fingernails tinged blue or purple
- Is wheezing or breathing quickly
- Seems especially drowsy
- Is showing signs of dehydration (fewer wet diapers, crying without tears)
As always, your intuition is often right. If you’re snuggling your little one and doing your best to keep them comfortable, but they don’t seem right, a call to your healthcare provider is always ok. Also, remember that many children’s hospitals and insurance companies offer nurse lines free of charge for advice.
And hopefully, an RSV vaccine will be available soon, so severe RSV seasons like the one parents are going through this year are a memory of the past!
More important articles on RSV:
- 5 Key Signs of RSV
- The Dos and Don'ts of Fighting a Fever
- 5 Tips for RSV Relief At Home
- 5 Tips to Prevent the RSV Virus From Entering Your Home
- What Parents Need to Know About RSV
- How to Prepare For An Early RSV Season
- Why is RSV on the Rise Among Children?
Genevieve Kane, MSN, RN, is a mother of four and a registered nurse with a background in pediatrics. When she's not working, you can find her cooking up tasty family dinners or keeping up with her kids on a hiking trail in her home state of Colorado.
Be prepared for whatever sickness comes your way.
The Nozebot is a battery-powered suction device designed to clear nasal congestion in babies and children.