As temperatures cool and leaves turn brown, illnesses begin to run rampant. It is widely known that fall and winter are flu season, but this year another virus demands our attention: respiratory syncytial virus, more commonly known as RSV. In September, the first RSV vaccines came onto the market, and University of Minnesota Physicians (M Physicians) adult and pediatric infectious disease physician Beth Thielen, MD, is here to walk patients through the details.

What is RSV?

“RSV is a respiratory virus somewhat like SARS-CoV-2 or influenza that people may have heard about. It affects all ages of people, although we tend to think of it affect more very young children. It causes a disease that can range from no symptoms at all to a minor cold illness with nasal congestion and runny nose, to a potentially life-threatening disease affecting the lungs.”

How is RSV spread?

“RSV spreads through the exchange of secretions. So, people can spread it through runny noses, sneezing, coughing, touching objects after they’ve touched their mouth or nose, things like that.”

Who can receive the RSV vaccine?

“The first round of vaccine approvals that came out were for adults over 60. We did also just have another vaccine that was approved for pregnant people, and that specifically was approved in 30 to 36 weeks of pregnancy. That vaccine is really designed to protect the infant. The pregnant person will make antibodies that will get passed on to the fetus in utero, and those in antibodies will stick around in the baby and help them in the first months of life.

What do we know about the effectiveness of the vaccine?

“In terms of preventing lower respiratory tract disease, which is when the virus goes on to affect the lungs, it’s generally somewhere in the neighborhood of 80% effective for protecting against that. That’s really quite good, and potentially better than flu vaccines that we have. The RSV vaccine looks to be very promising at preventing those severe outcomes that we most care about. Now, wish we had the ability to make a vaccine that could keep you from entirely getting sick at all. That’s the Holy Grail of vaccinology for respiratory viruses, but we’re not there yet. The thing we can celebrate is that we’re preventing the most severe end of the disease that takes lives and lands people in the hospital. The vaccines do seem to be quite promising in that area.”

Is the vaccine for pregnant people the only option for protecting infants?

“There actually is another new product that’s not a traditional vaccine, it’s a monoclonal antibody that protects against RSV. It is one injection that protects for the whole season. The hope is that that provide an opportunity for protection to a lot more infants. The issue this season has been that there’s really limited supply available, so because of shortages we’re still having to restrict it somewhat. The vaccine for pregnant people is much more widely available than the monoclonal antibodies, so we’re generally recommending that if pregnant people have the opportunity to get vaccinated themselves, they go ahead and do that.”

How do I decide if I should get the vaccine?

“It’s really about personalizing it. People should have a conversation with their providers to talk about risk. Some things might be thinking about your risk of exposure. Are you around other people, and how much? How much can you do other preventative measures like stay away from sick people, wear masks, do good hand washing? Somebody who’s an elementary or preschool teacher, for example, is probably going to have much higher risk of exposure than somebody who is spending most of their time at home.There’s a lot of factors to take into account, and that is why I think it’s best left to a decision between the individual person and their provider.”