What if you could help your baby avoid the most common reason for hospitalization for children under one? With a simple shot, you may be able to do just that.
This fall is the second year the RSV shot is available to all babies 8 months and under, pediatrician Dr. Sameena Hassan of Novant Health Dilworth Pediatrics in Charlotte said. She shares below why she recommends it to parents.
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RSV and its symptoms
First, what is RSV?
“Respiratory syncytial virus” (RSV) is a common virus that for most people feels like a cold. Almost everyone has had it by age two. You and I have probably had it at least 20 to 30 times in our lives. It’s prevalent every year from late fall through early spring.
However, when kids under age 2 get RSV — especially those who are 6 months or younger, or who have heart or lung conditions — some of them will get very sick.
What are the symptoms of RSV?
RSV is “juicy.” There will be a river of snot pouring out of your sweet baby's face, and there’s a high-pitched, wet cough that I can hear down the hall and know it's RSV.
They usually look and sound a mess. They're working hard to breathe, and they sound super snuffly, wet and congested. Often, they’re otherwise pretty happy.
It's usually on day 4 to 6 when things reach a tipping point. There’s just so much mucus in both the upper and lower airways that some babies may struggle to breathe, eat or drink well. Some babies may develop bronchiolitis, an inflammation of the bronchioles (the smaller parts of the airways/lungs) that can be associated with respiratory distress and wheezing.
What happens to babies that develop these severe RSV symptoms?
Sometimes, we have to hospitalize them so they can get supplemental oxygen and/or IV fluids. The statistic is that 2 or 3 out of every 100 babies with RSV infection will end up needing hospitalization. That adds up to a lot of babies. In every hospital system I’ve been in, during winter, easily half of the pediatric floor is babies with RSV.
They're there for a short period of time, usually one to four days, to get a little oxygen, get some fluids, get over the worst of this. That's what we call "supportive care." There's no medicine to kill the RSV. You're just supporting the body as it deals with it. A very small percentage end up needing mechanical ventilation.
The new RSV shot: what it is, who can get it and when
Tell us more about the new(ish) RSV shot.
We’ve had an RSV shot for 20+ years that had great efficacy, but it was only approved for the most at-risk babies because it was very expensive and had to be delivered monthly during RSV season.
Now, we have something available for all babies under 8 months old. It’s covered by insurance and only needs to be given once, covering the whole RSV season.
It’s similar to the shot we've had for 20+ years in that it’s an antibody treatment. This means that we give the baby's body a huge dose of the antibody response it needs to fight RSV. (For science nerds: an antibody treatment is not a vaccine, since it does not activate the immune system to make its own response, and instead provides temporary protection through antibodies — a process called “passive immunization”).
Your baby may still get RSV, but this shot is 80% to 90% effective in preventing infants from being hospitalized due to RSV.
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Who is eligible for the RSV baby’s shot and when is it given?
The RSV shot is available during RSV season to babies under 8 months old. We usually give it during the first pediatric appointment in our office after your baby is born. If your baby didn't receive it then but is eligible, they can receive it during any well visit during RSV season.
We also give it to babies 8 to 19 months with health conditions (like heart or lung issues) that put them at a high risk for RSV. Some of these babies are eligible for two shots, covering two RSV seasons. Your pediatrician will help you figure it out.
I also want to note that pregnant women who are due during RSV season can get an RSV shot at their OB-GYN’s office between weeks 32 and 36 of pregnancy. In an ideal world, every woman would get that shot: It protects them and their baby for the whole season, and their baby doesn't need their own RSV shot if they get it.
Is the new RSV shot safe?
I understand the fear of hurting your baby, of taking a misstep. So I try to get people to understand what a huge difference it makes in the lives of all of our children to have access to vaccines. The mortality rate has decreased so much since vaccines became available, and the vaccine schedule was developed so that your child would be protected at all times.
I like to use a seat belt analogy: Many of our parents grew up without car seats or seatbelts — they just threw the baby in mom's lap and went home from the hospital. Sure, you'll probably make it home without an accident in the car today, but we all know you're safer with a seat belt on and with your child in a car seat. Similarly, it makes me really nervous to send a baby or a child out into the world with their vaccines not completely up to date.
By far, the single greatest contribution I make to the community as a pediatrician is vaccinating people and providing access to therapies like this RSV shot.
Any closing thoughts about RSV and the new shot?
Parents hear "RSV" and panic. I get it, and I want to educate them: yes, RSV is a huge burden on our health care system with lots of illness, lots of hospitalization, and lots of visits to my office with concerned parents — but really, it's a cold that we've named that we know causes a lot of disease. And now, we have tools to fight it.
