First RSV vaccine approved for elderly

Australia’s first vaccine against the potentially deadly respiratory syncytial virus has been approved, with adults over 60 now able to be vaccinated against the contagious lower airway disease.

Lisa Loader.

Australia’s first vaccine against the potentially deadly respiratory syncytial virus has been approved, with adults over 60 now able to be vaccinated against the contagious lower airway disease,

Many elderly people and children, especially those with chronic conditions, have been particularly vulnerable to RSV in the wake of the pandemic with immunity levels in individuals low as a result of lockdowns and lack of exposure to common pathogens.

The new protein-based vaccine developed by GSK Australia, dubbed AREXVY, will be initially available to adults aged over 60 on private prescription.

The approval of the vaccine by the Therapeutic Goods Administration follows the same vaccine being given the green light in the UK, the European Union, US, Canada and Japan.

RSV is spread by airborne droplets and causes symptoms including runny nose, cough, difficulty breathing and fever. In severe cases it can lead to pneumonia, respiratory failure and, in some cases, death. Those with diabetes, asthma, heart failure and chronic obstructive pulmonary disease are at much higher risk of hospitalisation from the virus, which is often associated with children, but can also hit the elderly hard, with over 25,000 Australians aged 60 and over diagnosed with RSV in 2023.

RAT tests are now available to check for Covid-19, flu and RSV in one test, with the virus form part of what has become known as the ‘tripledemic’ – the simultaneous spread of three major respiratory viruses.

Many patients who experienced severe disease from the virus say they had no idea until they contracted it how serious it could be.

Lisa Loader, 59, recently contracted RSV which was so severe she said she would “rather have Covid-19 27 times over”.

“I stayed up for two nights, terrified I was going to die,” the grandmother said. “It was the first time I thought about my own mortality.”

Ms Loader’s symptoms rapidly progressed and she was diagnosed with bilateral pneumonia. She developed a persistent hacking cough that was so severe and constant she could not talk and had to communicate with her doctor via written notes.

An asthmatic, she was so vulnerable in hospital to catching other infections that she was sent home with high-strength antibiotics and asthma puffers, with doctors fearing additional infections in the hospital could make her condition even worse.

It took 15 weeks for Ms Loader to recover.

University of Sydney public health expert Robert Booy said RSV could be just as severe as influenza and sometimes more so.

“The information we have from around the world is that RSV in older people can be comparable to flu in terms of severe disease, hospitalisation and intensive care admission,” said Professor Booy, an infectious diseases specialist and pediatrician.

Professor Booy said the new RSV vaccine had come just as the nation waits to see whether summer will bring a significant RSV wave in the wake of the pandemic “immune debt”.

“There are a bunch of young children and older people who due to separation and social distancing weren’t exposed to RSV for two or three years, and so now they’re naturally more susceptible and less immune,” he said. “So we may well be facing a bigger surge this year than we used to have before Covid came along.

“This vaccine is a great advance. I’ve been in infectious disease research for 30 years and this is the first new respiratory viral vaccine for RSV. And RSV is one of the big three respiratory viruses.”

Alan Paul, executive country medical director of GSK Australia, said the vaccine was set to save lives. “The availability of an RSV vaccine for adults aged 60 and over is the result of collaboration across academia, industry, and research centres. I am excited to see this innovation now become available for older adults in Australia, including those with underlying health conditions, who carry a substantial burden of disease with RSV infection,” Dr Paul said.