Respiratory syncytial virus (RSV) accounts for a significant number of infant hospitalisations in the UK. In response, the RSV vaccination programme has been rolled out across Great Britain.

4 minute read

What is RSV?

RSV or to give it its full name, respiratory syncytial virus, is a common virus that usually causes mild, cold-like symptoms. It is highly contagious, meaning it can be easily passed to others and is spread through coughing, sneezing, direct contact with someone who has the virus, or touching contaminated surfaces.

What are the symptoms of RSV?

RSV symptoms are usually similar to the symptoms of a common cold and may include: 

• Coughing

• Sneezing

• Runny or blocked nose

• Sore throat

• Reduced appetite

• Headache

• Lack of energy

• Fever (high temperature)

Babies may not have typical symptoms of RSV and may show symptoms such as:

• Irritability, fussiness or difficulty settling

• Refusal to feed/decreased appetite

• Lack of interest in playing

• Changes in their breathing such as shortness of breath or wheezing (noisy breathing)

Treatment for RSV

There is no specific treatment for RSV, and mild infection can normally be treated at home with:

• Rest

• Plenty of fluids

• Over-the-counter medication such as paracetamol or ibuprofen to relieve symptoms such as pain or fever

Is RSV dangerous?

Most cases of RSV get better on their own in a week or two, but sometimes RSV can lead to complications which can be serious and require hospitalisation.

Complications of RSV infection include:

• Dehydration

• Ear infections

• Acute bronchitis

• Bronchiolitis (inflammation of the airways)

• Pneumonia (inflammation of the lungs)

• Worsening of pre-existing conditions such as asthma, chronic obstructive pulmonary disease (COPD) and congestive heart failure 

• Low oxygen levels (hypoxia)

• Respiratory failure

Who does RSV affect?

Anyone can get RSV, but babies, some young children, people with weakened immune systems and older adults are more likely to get seriously ill from RSV infection.

In the UK, complications from RSV infection account for around 30,000 hospitalisations of children under 5 every year, and 20 to 30 infant deaths.

Complications of RSV account for around 9,000 hospitalisations in people aged over 75 in the UK each year. 

Those at increased risk of complications of RSV include:

• Babies, especially those born prematurely, or aged six months or younger

• Some children including those with congenital heart disease, chronic lung disease or neuromuscular disorders like muscular dystrophy

• Children or adults with weakened immune systems due to disease or certain medications

• Adults with heart disease or lung disease

• Older adults

Is there a vaccine against RSV?

In November 2023, the first vaccine against RSV was licenced for use in the UK by the Medicines and Healthcare Products Regulatory Agency (MHRA).

The vaccine, called Abrysvo is manufactured by Pfizer and has been selected by the UK government to supply 5 million doses over the next two years. 

Abrysvo works by activating the immune system to produce antibodies against RSV.

In pregnant women, the vaccine works by boosting the mother’s immune system to make antibodies against RSV infection. This immunity passes to the baby, reducing the risk of severe RSV lung infection by around 70% in the first six months of life.

The new vaccination programme for RSV

Following close examination of the evidence, the Joint Committee on Vaccination and Immunisation (JCVI) recommended that a vaccination programme against RSV be introduced in the UK to protect babies under six months of age and older adults.

The UK is the first country in the world to roll out a vaccination programme for RSV, aimed at curbing the spread of RSV infection, reducing serious illness in at-risk groups and relieving the burden on the NHS, particularly during the winter months.

Who will be eligible for the RSV vaccine?

From 1 September 2024, the RSV vaccine will be offered to:

• Adults turning 75 years old on or after 1 September 2024

• Adults already aged 75 to 79 years on 1st September 2024

• All pregnant women from 28 week’s gestation

How is the RSV vaccine given?

A single dose of the RSV vaccine is given by injection into a muscle in your upper arm. Clinical trials have found that a single dose of the RSV vaccine provides good protection against RSV for at least two years (this is likely to be longer).

Pregnant women should receive the RSV vaccine in every pregnancy.

Is vaccine hesitancy likely to be a problem?

Vaccine hesitancy is defined by the World Health Organization (WHO) as the “delay in acceptance or refusal of vaccines despite availability of vaccination services”. 

Vaccine hesitancy has been a growing problem around the globe as misinformation and conspiracy theories spread like wildfire on social media. Vaccination rates among children in particular have declined in recent years, prompting an NHS catch-up campaign to urge parents to book their children in for missed vaccinations such as measles, mumps and rubella (MMR).

Factors contributing to vaccine hesitancy

The 3C Model of Vaccine Hesitancy outlines three major factors that contribute to vaccine hesitancy around the world:

• Complacency — occurs when the perceived risk of vaccine-preventable disease is low, and vaccination is therefore not considered important

• Confidence — lack of confidence in vaccines may stem from distrust of the safety and efficacy of vaccines, as well as the health care system and the motivation of government and policymakers

• Convenience — relates to physical availability, affordability, access and ability to understand information (language and health literacy)

By educating healthcare providers on the primary reasons for vaccine hesitancy, the NHS hopes to increase vaccine uptake by improving education, access and awareness.

While it’s impossible to predict how many people will take up the offer of the RSV vaccine, recent figures are promising.

A 2023 survey by the UK Health and Security Agency, questioned around 1000 participants with children aged two months to five years. Findings included:

• Respiratory syncytial virus (RSV) was the most frequently recalled health issue that parents had seen or heard about in the past 12 months

• RSV was rated as very serious by 58% of parents of babies and younger children

• 89% of parents questioned agreed that vaccines work, and 84% felt that they are safe

How do I get an RSV vaccine?

For pregnant women, the RSV vaccine should be offered by your maternity healthcare team from the 28th week of pregnancy. If you haven’t been offered the vaccine by your 28-week antenatal appointment, contact your maternity service to make an appointment.

If you think that you have missed your vaccine, contact your maternity team. Having the vaccine after the 28th week of pregnancy will still provide some protection from RSV infection. You can have the vaccine at any time from 28 weeks until you have the baby. 

For older adults, you will be invited for your vaccination by your GP, or healthcare provider once you turn 75, or if you are already aged 75 to 79 years. If you are eligible for the RSV vaccine and don’t receive an invitation, contact your GP surgery.

Summary

RSV is a common, but potentially serious and life-threatening condition. Particularly among babies in the first six months of life and older adults.

From September 2024, the UK will roll out an immunisation programme to pregnant women and adults over 75 to reduce the spread of RSV infection and relieve the burden on the NHS.

For more information on the RSV vaccination programme, contact your GP or healthcare provider.