New RSV shots could sharply reduce hospitalizations this winter, Alaska health officials say

State health officials said this month they’re hopeful newly approved RSV protections could mean significantly fewer hospitalizations in Alaska from an upper respiratory illness that crowded pediatric units last winter.

Two new RSV vaccines for older adults, and a new monoclonal antibody treatment that protects infants and young children from the illness, will be available in the state as soon as October, health officials said.

“We have the opportunity to have about 80% less infant RSV in our hospitals and clinics this year,” said Dr. Liz Ohlsen, a staff physician with the Alaska Department of Health.

“This is the first time ever we have protections in the form of immunizations against RSV,” said Sarah Aho, program manager with the state’s immunization program. “It’s amazing.”

Respiratory syncytial virus, or RSV, is an upper respiratory illness that can infect the lungs and cause difficulties in breathing, as well as fever and a cough. It can range from very mild to very severe, and is the leading cause of hospitalization for infants in the U.S.

It is often most serious for infants and children under 5, older adults, pregnant women and immunocompromised people, according to the federal Centers for Disease Control and Prevention.

Last year’s flu and RSV season was particularly bad nationwide and in Alaska, where hospitals reported full pediatric units while the contagious illnesses made their rounds through the fall and winter.

This year, RSV cases have been reported in the Southeast U.S. in recent weeks, but it has not yet taken off in Alaska, Ohlsen said.

Two RSV vaccines were approved for adults 60 and older this year: Abrysvo and Arexvy. Aho and Ohlsen encouraged Alaskans in that age group to talk to their doctor about the benefits and risks of getting vaccinated.

The Food and Drug Administration in August also approved Abrysvo for use in pregnant women to protect their infants from severe cases of RSV.

Nirsevimab, a monoclonal antibody that’s designed to protect infants against RSV and sold under the brand name Beyfortus, was approved in July.

Aho described the antibody as a form of protection that works by “prepping the body” to recognize and attack the infection.

In the state, rates of RSV among children and infants have often been highest in Western Alaska and other rural areas, where families often have more limited access to health care and have to travel long distances for treatment, Ohlsen said.

The virus can also cause pneumonia, which can make older adults very sick.

The CDC estimates RSV causes as many 80,000 U.S. hospitalizations and 300 deaths in children under the age of 5 annually, and 160,000 hospitalizations and 10,000 deaths for adults older than 65.

The CDC has recommended that all infants under 8 months “born during or entering their first RSV season” receive a single dose of the treatment, while infants and children ages 8 months to 19 months who are at increased risk for severe RSV disease should get one dose before or during their second season.

The three new RSV immunizations are expected to be available to Alaskans as early as next month, Aho said.

Aho and Ohlsen said that until this year, hospitals in Alaska haven’t been asked to report RSV cases and hospitalizations to the state, which means there is limited data on the illness’s impact here, especially recently.

The state is now recording that data in an effort to better track where, when and how RSV spreads, Aho said.

“Everyone felt like it was a big problem last winter, but we didn’t have a quantitative way to assess it,” Ohlsen said.

Despite a sharp decline in routine childhood immunizations during the pandemic that’s been slow to rebound, Aho said the latest immunization data from the state shows recent improvements to that rate. She’s hopeful more families will opt to protect their young babies and children against RSV this fall.

The vaccines for older adults will be available “anywhere you can get a flu shot,” Aho said. For infants, the monoclonal antibodies will be available at clinics and in pediatrician offices soon.

“October is the big push to get everyone we can vaccinated against RSV,” Ohlsen said, adding that this is also the month to get COVID-19 and flu shots as well.