RSV vaccine reviewed; seniors in the risk zone

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TORONTO-

As pediatric hospitals fill up with young children sickened by respiratory syncytial virus (RSV), doctors worry that older adults will be the next wave to become seriously ill.

“Right now, all the razors are focused on the kind of thing that’s happening in our pediatric hospitals,” said Dr. Samir Sinha, director of geriatrics at Sinai Health and University Health Network in Toronto.

“It’s almost a snapshot of what we think will also happen in our adult hospitals.”

Infectious disease experts have reported an earlier and tougher-than-usual RSV and flu season, in part because the COVID-19 pandemic health measures in previous years also protected against these viruses.

But seniors are also vulnerable to serious illness this year as more RSV circulates — and it’s only a matter of time before the spread moves from children to grandparents, Sinha said.

“We’re concerned this year we’re going to see a record number of older adults exposed to RSV,” he said.

Although data on current RSV hospitalizations by age group is limited, doctors are already starting to see “a growing number” of adults hospitalized for RSV along with influenza and COVID-19, Sinha said.

The Public Health Agency of Canada does not collect age-specific data on RSV hospitalizations, it said in a statement to The Canadian Press.

“RSV and influenza are two infections that have always had a disproportionate impact on the very young and the very old,” said Dawn Bowdish, Canada Research Chair in Aging and Immunity and an immunologist at McMaster University in Hamilton.

That’s because a child’s first RSV infection tends to make them the sickest, and then they have some immunity throughout their lives. But that ability to mount a strong immune response and fight infections declines among seniors, she said.

On top of that, those 65 and older tend to have less resilient lungs, she said, so they are “much more vulnerable to lung damage” from respiratory infections like RSV.

Although there are many young children who are sick with RSV, they tend to recover, while older patients can be much more severely affected, Sinha said.

“Our big concern right now is that we know that the actual burden of disease, annually, tends to be the greatest when it comes to RSV among older people. That’s where we see the vast majority of hospitalizations and deaths occur, ” he said.

HOW TO PROTECT SENIORS AS HOLIDAY ENTRY

Families may decide to protect seniors by minimizing contact with vulnerable seniors during this rise in respiratory illnesses, but that won’t be realistic come the holidays, Bowdish said.

“(If) you have an older adult who lives in long-term care, or a family member who is a little bit socially isolated … the pull of togetherness is just so strong and so important,” she said. “I would never recommend complete isolation.”

Unlike COVID-19 or the flu, there is currently no vaccine for RSV — which makes other preventive measures even more important, she said. These include wearing a mask and not visiting your elderly loved one if you feel unwell.

POTENTIAL RSV VACCINE FOR SENIORS

In a statement Thursday, Health Canada said it had received a submission from GlaxoSmithKline (GSK) on Oct. 25 for an RSV vaccine for adults age 60 and older.

In addition, Pfizer has notified Health Canada that it plans to submit two RSV vaccine candidates for consideration: one for seniors and one for pregnant women, the statement said.

“Once a submission is received, as with all vaccine submissions, Health Canada reviews it using an independent process based on scientific rigor and medical evidence,” it said.

Both Sinha and Bowdish say a safe and effective RSV vaccine would be an important tool to protect seniors.

“The preliminary data that I’ve seen from the various manufacturers is actually quite promising,” Sinha said.

These data appear to show a “fairly good level of effectiveness” and an ability to significantly reduce hospitalizations and other serious outcomes from RSV among seniors, he said.

“We’re pretty hopeful … that we could potentially get an RSV vaccine approved for older adults as early as next year.”


This report from The Canadian Press was first published on November 25, 2022.


This story was produced with financial assistance from the Canadian Medical Association.

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