RSV’s Shift in Threat Perception
While RSV has long been considered a common respiratory illness affecting young children, recent revelations from UK scientists underscore its potential danger to older individuals.
Traditionally thought of as a childhood ailment, RSV is increasingly identified as a cause of severe respiratory illness, and even death, in older people, particularly those with underlying heart or lung conditions or frailty.
Prevalence and Impact on Older Population
RSV is estimated to be responsible for over 29,000 hospitalizations in individuals over 65 in the UK annually, with a majority occurring in adults aged over 75.
The risk of severe complications from RSV increases with age, exacerbating chronic conditions and potentially leading to fatal outcomes.
Experts suggest that the impact of RSV on hospitalizations and deaths may rival that of the flu.
JCVI’s Urgent Vaccination Recommendation
Recognizing the underdiagnosis and undertreatment of RSV due to overlapping symptoms with other illnesses, the Joint Committee on Vaccination and Immunisation (JCVI) advocates for a nationwide vaccination campaign.
Specifically, they propose inoculating 5.5 million over-75s in Britain using newly-developed vaccines targeting RSV.
Risk Factors and Repeat Infections
The risk of RSV infections, especially repeat occurrences, rises with age, making chronic conditions more severe.
Older adults, every three or four years, may experience an RSV infection that is often mistaken for a common cold.
Those with heart failure or chronic lung disease face heightened vulnerability to the adverse effects of RSV infections.
Seasonal Timing and Symptom Challenges
Typically, the RSV season in the UK peaks between October and December, presenting symptoms such as a runny nose, decreased appetite, coughing, sneezing, wheezing, and fever.
However, the full range of symptoms is not yet fully understood, contributing to the virus’s under-diagnosis. Older patients may exhibit atypical symptoms, such as confusion and lethargy, leading to misdiagnosis.
Need for Improved Surveillance and Testing
RSV infections are often missed due to limited testing methods. Traditional diagnostic approaches using nasal mucus may yield false negatives in older individuals, necessitating more comprehensive testing involving lung sputum and spit samples.
Improved surveillance is crucial to obtaining accurate data on the prevalence and impact of RSV.
Vaccination Campaign Potential
With the introduction of RSV vaccines by GSK and Pfizer, the JCVI recommends a national immunization campaign.
These vaccines, Arexvy and Abrysvo, have been approved for older adults and are deemed effective for at least two years.
The potential benefits of preventing RSV-related hospitalizations and deaths among older individuals make the vaccination campaign highly cost-effective.
Reassurance on Safety and Over-Vaccination Concerns
Experts assure the safety of RSV vaccines, alleviating concerns about potential side effects.
The proposed vaccination campaign aims to reduce the strain on the healthcare system during the winter season, where respiratory viruses, including RSV, contribute to increased hospitalizations.
Individuals aged 60 and above can opt for private vaccination, with Professor Andrew Pollard emphasizing the minimal impact on the immune system compared to the daily onslaught of various pathogens.**
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