“FDA Approval of Arexvy RSV Vaccine Brings Hope to Older Adults with Respiratory Infection”

Approval of the Arexvy respiratory syncytial virus (RSV) vaccine by the US Food and Drug Administration (FDA) brings hope to those 60 and older who contract this infection and those who usually do not it is detected, although it can cause comorbidities in patients with respiratory conditions, according to health professionals consulted.

“It is thought that the impact of respiratory syncytial virus in adults is quite similar to that of influenza, which we know hits every year in the coldest months and has associated mortality, especially older people, with depressed immune systems or with chronic and particularly pulmonary diseases”, explained the infectologist Humberto Guiot to THE SPOKESMAN.

When an adult patient arrives at the hospital with respiratory complications, they are tested for asthma, coronavirus, or influenza, but they are not tested for respiratory syncytial virus and there are not many data on the matter on the Island.

However, data from the United States indicate that respiratory syncytial virus causes 10% of pneumonia hospitalizations, and about 12% of people with obstructive lung disease see symptoms exacerbated, according to Guiot.

“It is difficult to test for respiratory syncytial virus in Puerto Rico. There are one or two hospitals that do them, but it’s more a matter of cost,” she said.

“They are usually molecular panels and could cost $300 to $500, and health systems cannot incur the cost of routinely paneling all patients who come to the emergency room with a pulmonary exacerbation,” he added.

Also, there are no specific antivirals for adults with respiratory syncytial virus, so it is managed symptomatically, such as giving it oxygen or anti-inflammatories, Guiot said.

“As we have diagnostic and therapeutic challenges, the news that we are going to have the vaccine is very good. The data is very encouraging, because it is seen that among the people who received the vaccine there was more than an 80% reduction in infections by the virus, and we are talking about that this would result in a significant reduction in the number of hospitalizations for this cause. , as well as mortality”, he affirmed.

According to the FDA’s website, 12,500 people received the vaccine, versus 12,500 who received a placebo. The vaccine significantly reduced the risk of lower respiratory tract infections by 82.6%, while it reduced the chance of complications associated with the virus by 94.1% in patients 60 years of age or older. This vaccine was reportedly developed after 60 years of research.

At the moment, Arexvy, produced by GlaxoSmithKline Biologicals, has to go through the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) “and should be available in the coming weeks Guiot said. “It will also have to go through the approval of health plans to cover it,” she added.

The infectologist made it clear that this new vaccine does not cover other types of viruses, so he invited the community to continue receiving the annual influenza vaccine, the pneumococcal vaccine, and the bivalent vaccine against the coronavirus.

heart attacks and strokes

The infectologist Lemuel Martínez indicated to THE SPOKESMAN that approximately 15 years ago the high incidence of the virus in older adults began to be recognized, but it had been detected for longer that respiratory diseases could cause complications that lead to heart attacks or strokes.

“If heart attacks were random, there would not be an increase in summer and Christmas,” explained Martínez.

“You see seasons of heart attacks and that doesn’t make sense, unless there is something that is driving them. Catarrh hits one every day, and many people with viral respiratory conditions are sent home if they don’t have major problems, but some even die and the medical class does not have good diagnostic tools to detect them, ”he pointed out.

The infectologist pointed to a study carried out in Canada, in which patients were tested for respiratory viruses through molecular tests and were monitored for about two weeks.

“They were able to prove what we have always said: there has been a trend that as respiratory viruses increase, heart attacks increase; and they saw that in the next six days after having a respiratory event, the risk of heart attacks increased three times. If it was influenza, it was double, ”he explained.

Martínez regretted that the study came out just before the pandemic, “and I think neither the medical community nor anyone else emphasized it, because it was lost.”

For the infectologist, the vaccine represents a better chance to prevent heart attack patients from being further debilitated by respiratory syncytial virus.

“In patients with heart problems, it is common for them to have to take two to five pills, which is a burden on the health system. It is a very large chain of events that, if we can avoid it, will undoubtedly have a huge impact ”, he concluded.

On the other hand, Iris Cardona, chief medical officer of the Department of Health, informed THE SPOKESMAN in written statements that “the vaccine was approved by the FDA on May 3. We are waiting for the Advisory Committee on Immunization Practices to publish the recommendations.”