COVID, Flu and RSV Vaccine Update

It is that time of year again when we encourage all of our patients 6 months and older (who do not have a medical contraindication) to get their Flu shot. In addition to the Flu shot, there is an updated COVID-19 vaccine and RSV monoclonal antibody (not actually a vaccine) called Beyfotus that were recently approved.

Vaccine Availability

Flu Vaccine: we currently have Flu Shots (6 m/o and up) and Flu Mist (spray in the nose for children 2 y/o and up) available
COVID Vaccine: available for all ages
RSV Monoclonal Antibody (Beyfortus): available now for infants < 6 months old

For more information about these products and why we recommend them, see below.

RSV Monoclonal Antibody (Beyfortus)

What is it?

Beyfortus (Nirsevimab) is a monoclonal antibody approved to prevent Respiratory Syncytial Virus infection in infants and toddlers. RSV is a respiratory infection that causes cold symptoms, but for infants and toddlers it can also cause bronchiolitis, an infection of the small airways of the lungs. It is estimated that RSV results in the hospitalization of 58,000 to 80,000 children < 5 years old per year with 100-300 deaths. Normally to protect children from infections we vaccinate them by exposing the immune system to a part of the infection. The immune system then learns what the infection is and creates antibodies and memory cells to protect against future infection. The challenge with RSV is that making a vaccine against it is very difficult, and even if a vaccine were to be effective, the infant would be at risk of infection while the immune system was learning from the vaccine. Given that this virus is most dangerous for young infants, the vaccine model is not ideal. Instead of giving a vaccine to protect infants, we can now give infants the protective antibodies against the infection. This is similar to how mothers pass on protective antibodies against infection through the breast milk. By giving the antibodies directly, your child will have protection against RSV immediately after the infection, not weeks or months later like with most vaccines.

Why get it?

Similar to the Flu and COVID vaccines, getting Beyfortus does not guarantee protection from getting RSV infection. However, in the clinical studies 1 dose of medication reduced the risk of severe infection requiring medical attention by 74.5% and provides protection for 5 months. Given that RSV is the leading cause of hospitalization in infants this is huge! Prevention of severe disease is especially important for RSV because there is no treatment.

Who can get it?

All infants younger than 8 months born during or entering their first RSV season. Due to limitations of supply, the injection is currently only being offered to infants with high risk medical conditions or < 6 months old.
Infants and children aged 8 through 19 months who are at increased risk of severe RSV disease and entering their second RSV season.

What are the side effects?

The injection is very well tolerated with the most common side effects being rash or irritation at the injection site.

Flu Vaccine

What is it?

A new flu vaccine is recommended every fall because the Influenza virus that causes flu is constantly mutating. As a result, humans are susceptible to new versions of the Influenza virus every fall and winter. Scientist try to predict which strains will be most prevalent each year and create a vaccine to protect against those strains. The result is a quadrivalent vaccine that protects against 2 strains of Flu A and 2 strains of Flu B.

Why get it?

Unfortunately getting the Flu vaccine does not guarantee your child will not get the flu, however it does reduce the risk of getting the flu by 40-60%. The main benefit of the Flu vaccine is that it greatly reduces the risk of severe illness, hospitalization, and death related to the flu.

A 2022 study showed that flu vaccination reduced the risk of severe life threatening infection by 75%.
A study conducted during the 2018-2019 flu season showed that vaccination reduced flu-related hospitalization by 41% and flu related emergency department visits by half.
A 2017 study showed that flu vaccination reduced the risk of flu-associated death by 51% among children with underlying high risk medical conditions and by 65% among healthy children.

What are the side effects?

Flu vaccine side effects are generally mild and go away on their own within a few days. Some side effects that may occur from a flu shot include soreness, redness, and/or swelling where the shot was given, headache (low grade), fever, nausea, muscle aches, and fatigue.

COVID-19 Vaccine

What is it?

Similar to the flu, the virus that causes COVID is continuously mutating. As a result, prior infection does not guarantee protection against future infection. The new COVID-19 vaccine targets XBB.1.5, a subvariant of Omicron that ripped through the United States last year. The new version of the vaccine is expected to keep more people from getting seriously ill with the virus during the winter months when respiratory viruses are most prevalent.

Why get it?

COVID-19 ranked 8th among all causes of deaths among children and young people aged 0 to 19 years in the U.S between August 1, 2021, and July 31, 2022.
Nearly 9,500 patients met the case definition for multi-system inflammatory syndrome (MIS-C) in children; there were 79 deaths among these patients.
Children with poorly controlled asthma are 3 to 6 times more likely to be hospitalized with COVID-19 than those without the condition.
Long COVID was seen in 16.2% of pediatric COVID-19 patients.
Receipt of 2 doses of COVID-19 vaccine is highly effective in preventing MIS-C in adolescents aged 12-18 years; estimated effectiveness was 91%.
Myocarditis after COVID-19 infection or vaccination is rare. In a 2021 report, only 86 children <16 years of age were diagnosed with myocarditis among nearly 65,000 (0.133%) children with COVID-19; additional research indicates that the risk for myocarditis is higher after COVID-19 infection than Pfizer or Moderna vaccination.
The vaccine is effective in preventing both asymptomatic and symptomatic SARS-CoV-2 infection among children and adolescents aged 5–15 years.

What are the side effects?

Children given COVID-19 vaccines have side effects similar to those faced by adults. The most commonly reported side effects include: pain, redness or swelling where the shot was given, tiredness, headache, chills, muscle pain, joint pain, and swollen lymph nodes. For children ages 6 months – 5 years old who received either Pfizer or Moderna vaccines, 98% of adverse events reported were non-serious; zero myocarditis events reported. A review of more than 240,000 doses given to young children found no indications of serious side effects.