Health
RSV is about to be tackled with a new vaccine in Australia — here’s what we know so far
Respiratory syncytial virus (RSV) gets noses running, but in the last few days it’s also got tongues wagging — ever since it was revealed a new vaccine would soon be made available in Australia.
The Therapeutic Goods Administration (TGA) has approved a protein-based vaccine for the prevention of lower respiratory tract disease caused by RSV.
The vaccine AREXVY, developed by pharmaceutical company GlaxoSmithKline (GSK), will be available through private prescriptions for those aged 60 and above.
“A lot of people forget that older Australians are very vulnerable to RSV so this sounds like a very exciting development for health,” Australian Medical Association (AMA) national president Steve Robson said.
Here’s what we know so far.
What are the symptoms in adults?
RSV infections can be especially severe among particular age groups, and symptoms can also differ depending on age.
“RSV is like many respiratory viral infections in that it hits the very young and the old especially,” University of Sydney infectious diseases paediatrician Robert Booy said.
According to state health authorities, early symptoms of RSV infection include a fever, a runny nose, a cough and wheezing, and can also include difficulty breathing and cyanosis (bluish or greyish colour of the skin).
“In very young children, they can get — as anyone can get — a cough and a fever and fast breathing,” Professor Booy said.
“But children can also stop breathing, whereas in adults it’s more likely that you get the symptoms of a classic cold.”
While babies with RSV are at risk of developing bronchiolitis — which could leave them in “hospital, even intensive care” — older children, teenagers, and young and middle-aged adults are “much less likely to get it severely”, Professor Booy said.
But RSV is by no means only a virus of early childhood.
“We’ve learned over the last 10 or 20 years that if you’re an adult and elderly — by elderly [I mean] over 75, but even if you’re over 60 — you’re more likely to get an RSV infection,” Professor Booy said.
“It’s more likely to be severe, it’s more likely to require medical attention.”
The AMA president told ABC Radio that infections could be especially serious in those “who have chronic lung disease, who have heart disease, who have immune compromise”, and that among those at risk are the hundreds of thousands of Australians “living in aged or residential care”.
“There are many, many hospitalisations of older Australians and, unfortunately, deaths of older Australians every year from respiratory syncytial virus,” Professor Robson said.
“While the vaccine may not necessarily stop you getting it — because it’s very, very common — it seems to really be very, very effective in reducing the chance of you getting serious complications like pneumonia or ending up in hospital.”
Why is this vaccine only for older adults?
The AREXVY vaccine will only be available for Australians aged 60 and over, and that’s because it has been “specifically designed for older people”, Professor Robson said.
“The results that have been seen from the US have been very, very encouraging,” he said.
“I think there’s been a lot of good news over the winter, and typically winter is when the RSV has a real effect.”
Professor Booy said the composition of the AREXVY vaccine reflected the needs of its target age group.
“It includes what we call an ‘adjuvant’ … which [is] a chemical that’s mixed with the vaccine which induces the human immune system to respond more strongly and to make more and better antibodies against the virus,” he said.
“We don’t use ‘adjuvanted’ viral vaccines in very young children, and different vaccines have been, and are being, developed for young children.”
How long are you contagious?
Potentially for several days.
“The average incubation period is five days, with a range of two to eight days,” the SA Health department’s website states.
Professor Booy said those with strong immune systems, “especially teenagers and young adults”, could get infected “with minimal symptoms”.
“You tend to be infections in the hours before you have even got symptoms and for three or four days after you’ve got symptoms.”
Is RSV a coronavirus?
Professor Booy said the RSV was distinct from a coronavirus, which derives its name from its crown-like spikes.
“It’s by no means a coronavirus,” he said.
“All viruses tend to have little protein spikes coming out of them.
“With RSV, there’s an F protein and a G protein. With coronaviruses it’s different proteins that are sticking out.”
So what about the name, and what does “syncytial” mean?
“A ‘syncytium’ is a collection of cells that bind together,” Professor Booy said.
“When they look at the virus under the microscope, it tends to group together in multiple copies in one place, and that’s a ‘syncytium’.”
When will the vaccine roll out?
That’s unclear, but the manufacturer has said it would be available for eligible patients “very soon” — a view shared by the AMA.
“I understand GlaxoSmithKline, who are the manufacturer, are applying to have it included as part of the national immunisation program,” Professor Robson said.
“If they’re successful in that then in due course we would expect it to be a routine vaccination — so a lot of those are funded or free for vulnerable groups.
“That’s something that’s in the pipeline.”
Professor Booy said his “best guess” was that the vaccine would roll out “within the next couple of months”.
How much will the vaccine cost?
That’s also unclear, and a spokesperson for GlaxoSmithKline previously said it could not detail the cost of a private prescription.
“The companies and the government have to come to a decision about what price is mutually acceptable,” Professor Booy said.
A Department of Health spokesperson has said “further details on supply and cost will be made available in due course”.
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