Texas is extending access to RSV immunizations for infants and toddlers due to high infection rates.
RSV, or respiratory syncytial virus, is a common respiratory virus that can be particularly dangerous for children under seven months old. The state will extend "seasonal immunization" until the end of April this year due to higher RSV activity.
"We are at the end of the historical season, but the numbers are not declining, they're persistent," said Dr. Donna Persaud, a pediatrician with Parkland Health and medical director of the organization's homeless outreach program. "For this time of the year, compared to last year, [infections] were a little bit higher."
Persaud said RSV can vary from year-to-year, and it isn't clear why infection rates are higher this year.
"Ever since I can remember in my training, the issue of declaring the season over has always been a little bit of a moving target," Persaud said.
She said there are several thousand more infections in Texas at this point in the year than there were last year. It's one of 48 states that will continue to offer the vaccine due to high infection rates.
Dallas County Health and Human Services' virus surveillance dashboard shows at the end of March, 7.7% of RSV tests were positive, compared to under 4.5% last year.
The immunization for RSV is a little bit different than other common vaccines. It's still a simple shot, like the COVID-19 vaccine or the flu shot, but it has "direct antibodies" – which provide protection instantly rather than taking days or weeks to develop immunity.
"If the next day [a baby was] in a situation where there is contact with someone with active RSV, they already have the antibodies that can block that," Persaud said. "Because we have a vaccine that is immediately effective, we're able to meet that unexpected persistence with continuing to immunize."
People who are pregnant can get an RSV vaccine – which helps supply the infant with antibodies it isn't able to produce yet.
RSV is so common that most children have been infected by age 2, but people can get infected by the virus more than once. However, RSV is the leading cause of hospitalization among children under a year-old – which is why Persaud said immunization is particularly important.
Doctors can give the vaccine to children at birth, and they recommend it for children up to seven months old. For children eight to 19 months old "who have known underlying conditions," Persaud said parents should talk to their child's provider about vaccination.
The vaccine recommendations are designed to provide needed protection to children when they are most vulnerable, according to Persaud.
Infants and young children have a "poorly developed" immune system because their bodies haven't had enough experience with different germs. That makes it difficult for their body to produce antibodies to fight infections. Persaud said that can increase a child's risk of severe outcomes, like hospitalization and death.
"When you get to eight to 19 months, the hospitalization rates are dramatically decreased," Persaud said. "This just is the dynamic nature and the way that babies grow. They are growing fast. Even when they're vulnerable, within a month, they can get to a point where their lungs, et cetera, heart, immune systems are functioning better, and their risk drops off."
Adults and older children can also get RSV but are at a much lower risk of severe outcomes.
One of the more unusual things about RSV, according to Persaud, is that the infection can start with a "non-breathing spell" without presenting other symptoms first. RSV can look like a cough or a cold but involves the baby producing a lot of "secretions," like mucus and sweat.
"A baby having difficulty eating and breathing are little bit more common and excessive because the secretions with RSV is so much more than the other viruses," Persaud said.
With growing skepticism about vaccines, Persaud said people should talk to their provider and seek information from trusted sources. She said for pediatric immunizations that includes the American Academy of Pediatrics and the CDC.
"Everyone who's getting a vaccine or any other medicine should always consider the benefits and the risks," Persaud said. "Consistently for vaccines, we find that the benefits far outweigh the risks and concerns."
Persaud said the most common risks include side effects like "transient" or temporary fever, pain and swelling at the injection site. But she said the benefits include lower risks of hospitalization, serious illness and death.
She also said studies, including after vaccines are introduced into the community, show absent or very low occurrences of severe outcomes from vaccines. There's also a reporting system used to track adverse effects that allows doctors to have access to data regarding side effects or serious effects.
"Any concern about disability or death…are rare to non-existent with the vaccines that we have today," Persaud said.
She recommends people keep an eye on what health departments are reporting and understand what risks people in their family have, including adults who may be at higher risk.
"If your child has not gotten it, we are recommending it until the last day of this month," Persaud said. "If you're unsure [if your child is considered high risk], please talk with your child's provider."
Abigail Ruhman is KERA's health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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