Not another vaccine, you say? Yes, and here’s why: The UK is set to introduce and roll out a new respiratory syncytial virus (RSV) vaccine — and for all the right reasons. As the first country in the world to have a national programme using the same vaccine to protect both its youngest and oldest populations against RSV, the UK is leading the charge against this often-overlooked virus.
What is Respiratory Syncytial Virus (RSV)?
According to the Department of Health England, respiratory syncytial virus, or RSV, infects around 90% of children within their first two years of life. Despite this staggering statistic, many professionals and members of the general public remain unaware of what RSV actually is and the potential risks it carries. RSV is a leading cause of respiratory tract infections and is an RNA virus belonging to the same family as human parainfluenza virus, mumps, and measles viruses. It’s particularly prevalent during the cold winter months, contributing to a significant burden on healthcare systems.
RSV is primarily transmitted through large droplets and secretions from infected individuals, making it highly contagious, especially in crowded settings. The incubation period—the time between infection and the appearance of symptoms—is relatively short, ranging from 3 to 5 days. According to the UK Health Security Agency’s guidance on RSV, while most infections result in mild respiratory problems, certain high-risk groups can develop severe complications, leading to hospitalisation and, in some cases, death.
In the UK, the RSV “season” typically runs through the winter months, a time when healthcare resources are already stretched thin due to seasonal illnesses.
Why Do We Need an RSV Vaccine?
So, why is there such a pressing need for an RSV vaccine? The Department of Health and Social Care reports that RSV is responsible for around 30,000 hospitalisations each year among children under the age of 5 in the UK, along with 20 to 30 deaths in infants. These figures alone are concerning, but RSV’s impact doesn’t stop with children. In older adults, over the age of 75, RSV leads to approximately 9,000 hospital admissions annually. Moreover, it is estimated that between 5,000 and 7,500 deaths occur in older adults due to RSV-related illnesses, with the vast majority being those over 75.
The introduction of an RSV vaccine adds a critical layer of protection, particularly for the most vulnerable populations. For children, the vaccine could drastically reduce the number of severe cases, leading to fewer hospital admissions and preventing tragic outcomes. For older adults, who often face a higher risk of complications, the vaccine represents a significant advancement in preventing illness and saving lives.
Beyond individual protection, the vaccine has broader public health implications. By reducing the incidence and severity of RSV cases, the vaccine will alleviate the growing stress on the NHS, especially during the winter months when the healthcare system is already under immense pressure from flu and other respiratory illnesses. Preventing hospitalisations will free up critical resources, allowing the NHS to provide better care for those who need it most.
Who is the RSV vaccine available for in the UK?
The RSV vaccine is ground-breaking, being the first in the world that can be administered to both young and old populations. While most cases of RSV manifest as mild respiratory symptoms, those in high-risk categories can develop severe, life-threatening complications. Therefore, the vaccine is especially important for these vulnerable groups.
The Department of Health, UK Security Agency, and Green Book: Chapter 27a identify several high-risk categories:
- The very young (under the age of 1): Infants under 6 months are particularly vulnerable to severe RSV infections, such as bronchiolitis and pneumonia, which often require hospital admission. Additionally, premature babies and those with underlying chronic lung conditions are at even higher risk.
- By their first birthday, over 60% of children will have been infected with RSV, with the figure rising to 90% by the age of 2. However, it’s important to note that antibodies developed after an early childhood RSV infection do not provide lifelong immunity, meaning reinfection can occur throughout a person’s life.
- The older population (75 and over): There is significantly less data on RSV in adults and older populations, partly due to a lack of recognition and insufficient testing for the virus in these age groups.
- Elderly patients are not as thoroughly investigated for RSV as children are. The virus is less detectable in respiratory secretions in adults, which may lead to an underestimation of RSV’s true impact. Older adults, particularly those with chronic health conditions or compromised immune systems, are at high risk for severe RSV infections, which can exacerbate existing health issues and lead to serious outcomes. RSV also poses a significant burden on immunocompromised individuals, making them more susceptible to severe illness and complications.
The RSV Vaccine Rollout
The rollout of the RSV vaccine represents a major public health initiative, with guidance taken from the Green Book: Chapter 27a and the UK Health Security Agency’s recommendations for RSV vaccines in older adults and pregnant women.
In England, the rollout of the vaccine will begin on 1st September 2024. Wales and Northern Ireland are also planning to launch their vaccination programmes in September, while Scotland got a head start, beginning on 12th August. This coordinated effort across the UK aims to maximise the impact of the vaccine ahead of the winter season.
The vaccine will be offered to:
Pregnant women over 28 weeks: This will help protect newborn babies, who are particularly vulnerable to severe RSV infections.
Adults over 75 years old: A routine vaccination programme will be established for this age group, with an additional one-off campaign targeting those between 75 and 79 years old.
Individuals aged 75-79 will be offered the vaccine through their GP, and those turning 75 will also be eligible for vaccination. Pregnant women who are at least 28 weeks along should consult with their maternity services or GP to receive the vaccine.
While the vaccine can be administered at any time of the year, prioritising vaccination before the onset of winter will have the greatest impact. By vaccinating as many eligible people as possible before the cold months, the NHS hopes to provide protection when it is needed most and reduce the spread of the virus within communities.
Which Vaccine and How It Works
According to data from the Green Book: Chapter 27a, the Abrysvo® Pre-F RSV vaccine (Pfizer Limited) has been approved for use following rigorous clinical trials overseen by the Medicines and Healthcare products Regulatory Agency in November 2023. The vaccine was tested in over 17,000 adults aged 60 and older, as well as in more than 4,000 pregnant women, demonstrating its efficacy and safety across different demographics.
The technology behind the vaccine is both sophisticated and effective. It works by taking a small piece of DNA from the protein of the RSV virus and inserting it into a manufactured cell. These cells are then cultured to grow and produce the protein. The protein is subsequently purified and used in the vaccine formulation. Once introduced into the body via injection, the vaccine stimulates the immune system to produce antibodies against RSV, thereby providing protection against the virus.
The vaccine also contains additional ingredients, such as stabilisers and emulsifiers, which help maintain its stability and effectiveness. The inclusion of these components ensures that the vaccine remains potent and safe for administration across various populations.
The approval of the Abrysvo® Pre-F RSV vaccine marks a significant milestone in the fight against RSV, offering a new tool to protect vulnerable populations and reduce the burden of respiratory illnesses on healthcare systems.
Summary and conclusion:
With the introduction of the RSV vaccine, the UK is taking crucial steps forward in preventing the spread of the virus among its most high-risk populations. By proactively addressing the risks associated with RSV, the UK is not only preventing serious illness and the possibility of death, but also alleviating the significant pressures that the NHS already faces. Reducing attendances and admissions to hospitals can result in faster services, more available beds, and fewer hospital visits for high-risk individuals. This initiative underscores the importance of global health and safeguarding public well-being, highlighting the UK’s commitment to addressing the RSV winter epidemics.
Interested to Learn More?
Did you know? August is National Immunisation Awareness Month! Why not further your knowledge by signing up to our brand NEW RSV short course below.
Respiratory Syncytial Virus (RSV) Short Course – Elearning
This RSV short course is part of the ‘Health Academy Short Course’ series and provides clinicians with specific information related to Respiratory Syncytial Virus (RSV) and the RSV vaccines. This course provides 1 hour of CPD.
- Green Book on Immunisation chapter 27a Respiratory syncyntial virus (RSV) (publishing.service.gov.uk)
- National RSV vaccination programme announced – GOV.UK (www.gov.uk)
- Respiratory syncytial virus (RSV): symptoms, transmission, prevention, treatment – GOV.UK (www.gov.uk)
- RSV vaccination of pregnant women for infant protection: information for healthcare practitioners – GOV.UK (www.gov.uk)
