Recent data shows that a wave of the highly contagious respiratory syncytial virus is beginning to sweep across the United States, sending more infants and young children to the hospital.
The RSV outbreak comes as the country enters the broader fall and winter respiratory virus season, which is also typically marked by increased transmission of illnesses like COVID-19 and influenza. But RSV is the leading cause of hospitalization for infants nationwide, and it poses a particular risk to the youngest babies, which is the main reason why health experts recommend that pregnant women get closer to their delivery date or vaccinate their newborns.
“If you have never received an RSV vaccine, now is the perfect time to get one,” the Los Angeles County Department of Public Health said in a statement to The Times.
Health officials warn that respiratory syncytial virus can be spread by coughing or sneezing, as well as by touching contaminated surfaces, such as doorknobs, and by touching your face before washing your hands.
About 1.2% of emergency room visits nationwide among infants younger than 1 year old were due to RSV in the week ending Oct. 11, compared with 0.4% a month earlier, according to data released by PopHIVE, a project led by the Yale School of Public Health.
“The RSV wave is starting to take hold,” epidemiologists Katelyn Jetelina and Hannah Totte wrote in the blog Your Local Epidemiologist.
According to the Centers for Disease Control and Prevention, RSV can be dangerous to infants, older adults, and people with certain medical conditions. The California Department of Public Health says RSV can cause pneumonia and a severe inflammation of the small airways in the lungs called bronchiolitis.
Generally speaking, about 2 to 3 percent of young infants are hospitalized with RSV each year, according to the CDC. Most children hospitalized with acute respiratory illness caused by RSV were previously healthy, according to a study published in the journal Pediatrics.
They may need oxygen or intravenous fluids or even a ventilator to help them breathe, according to the CDC.
Unlike influenza and COVID-19, there are no antiviral drugs to treat RSV once you become infected.
State health officials say the combined activity of respiratory illness caused by RSV, influenza and COVID-19 in California is currently considered “very low.”
But the Los Angeles County Department of Public Health said “we are starting to see the beginning of the respiratory virus season.”
Health officials in Santa Clara County, Northern California’s most populous county, have reported “moderate” levels of RSV in wastewater from San Jose, Palo Alto and Sunnyvale.
If you haven’t been vaccinated yet, now is the perfect time to get vaccinated, “especially before there may be a subsequent increase in respiratory virus activity,” said Orange County Health Officer Dr. Regina Chinsio-Kwong.
The RSV vaccine is recommended for pregnant women between 32 and 36 weeks gestation (about one to two months before their due date), as well as for everyone 75 and older, and for people 50 to 74 years old with underlying medical conditions such as diabetes, cancer, kidney disease, a weakened immune system, asthma, or heart disease. Vaccination is also recommended for individuals living in nursing homes or long-term care facilities.
If a pregnant woman has not been vaccinated against RSV, officials recommend that her baby be vaccinated.
The RSV vaccine is fairly new, being launched in 2023. There are currently three brands: Moderna’s mResvia, Pfizer’s Abrysvo and GSK’s Arexvy. All three vaccines can be used in older adults, but only the Pfizer vaccine can be used in pregnant women.
Starting that year, babies can also be immunized with monoclonal antibodies, which are technically not vaccines but function similarly in this case.
Older adults who have received the RSV vaccine usually do not need another dose.
The arrival of the vaccines comes on the heels of a particularly brutal respiratory virus season in 2022-23, when California was hit hard by a “triple outbreak” of respiratory syncytial virus, influenza and coronavirus that put a huge strain on hospitals.
Unlike the RSV vaccine, influenza and COVID-19 vaccines are generally recommended before each fall and winter viral respiratory season. According to the California Department of Public Health, seniors 65 and older can get the coronavirus vaccine every six months.
Chinsio-Kwong said people can get RSV, flu and COVID-19 vaccines during the same visit.
“It is considered best practice to administer all eligible vaccines immediately as it helps avoid missed opportunities due to scheduling issues,” she said.
It is recommended that everyone 6 months of age and older get a routine flu vaccine once a year.
As for coronavirus, anyone who wants a vaccine can get one. The California Department of Public Health specifically recommends vaccination for everyone 65 and older, infants 6 months to 23 months, children and teenagers who have never been vaccinated, people with certain health risk factors and those in close contact with them.
The California Department of Public Health also recommends that pregnant women get the COVID-19 vaccine.
After concerns earlier this season about how difficult it might be to get a coronavirus vaccine, pharmacists and California health officials now say it will be relatively easy.
The controversy erupted in late summer over confusing guidance from the agency overseen by Health and Human Services Secretary Robert F. Kennedy Jr., who disparaged vaccinations.
There was a time when the U.S. Food and Drug Administration belatedly approved COVID-19 vaccines only for those 65 and older and younger people with underlying health conditions. The CDC’s unprecedented delay in releasing its own recommendations has led to dissatisfaction among many people about vaccinations.
In some states, that means people, including seniors, are being turned away from getting coronavirus vaccines at local pharmacies even as a late-summer vaccination rush unfolds. At one point, the powerful CDC Advisory Committee on Immunization Practices came close to recommending that the coronavirus vaccine be available only by prescription.
On Oct. 6, CDC acting director Jim O’Neill officially rescinded the agency’s recommendation that adults under 65 receive updated COVID-19 vaccines, saying that doing so should be based on “individual-based decisions” in consultation with health professionals.
Allison Hill, director of professional affairs for the American Pharmacists Association, said in a recent webinar that now “patients can walk into a pharmacy” and talk to a professional about getting a COVID-19 vaccine.
California also recently clarified state law to ensure pharmacists can independently administer COVID-19 vaccinations, said Dr. Erica Pan, director of the California Department of Public Health.
