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RSV

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News Flash: Generated by ChatGPT, edited by our staff

• FDA approves RSV vaccines for the first time. These vaccines target the respiratory syncytial virus, a seasonal lung-related illness, with recommendations for adults over 60 and pregnant women in specific gestational weeks.

• Infants under eight months born to mothers without the RSV vaccination can receive monoclonal antibody treatment, providing immunological protection against severe RSV symptoms.

• There are challenges in accessing RSV shots, including delayed processing by insurance companies and pharmacy shortages. Health officials urge residents to advocate for themselves, emphasizing the importance of timely vaccinations given the approaching RSV season.

For the first time, vaccines against the respiratory syncytial virus, or RSV — a lung-related illness that crops up during the fall and winter — have been approved by the U.S. Food and Drug Administration.

The FDA recommends that adults ages 60 and older receive a dose of the vaccine, either Pfizer’s Abrysvo or GSK’s Arexvy, within the next few weeks.

Women in their 32nd to 36th week of pregnancy at some point during September through January are also urged to receive Abrysvo.

For babies born to mothers who didn’t receive a dose of the RSV vaccine, the FDA has approved a monoclonal antibody treatment for infants eight months old and younger that will offer immunological protection against a common and prevalent respiratory condition that can lead to severe symptoms and hospitalizations.

Additionally, the Centers for Disease Control and Prevention recommend a dose of RSV antibody for children between eight and 19 months entering their second RSV season if they have chronic lung disease, are severely immunocompromised, have a severe form of cystic fibrosis or are American Indian or Alaska Natives.

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. File photo from Stony Brook Medicine

While local doctors welcomed the opportunity to inoculate residents, they said finding these treatments has been difficult.

“People are having a hard time getting” the vaccine, said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital.

Some pharmacies have told patients to come back, which decreases the likelihood that they will return for vaccinations in time, Nachman said.

Additionally, insurance companies have not immediately processed requests for vaccinations, which also slows the process, she said.

Nachman recommended that residents “continue to go back and advocate for yourself” because that is “the only way you’ll get what you need.”

RSV season starts around November, which means residents qualified to receive the vaccine or parents with infants need to reach out to their health care providers now to receive some protection against the virus.

Childhood illness

According to recent data, RSV caused 2,800 hospitalizations per 100,000 children in the first year of life, Nachman said. The range can go as low as 1,500 per 100,000.

However, that only captures the number of hospitalized people and doesn’t include all the times anxious parents bring their sick children to doctor’s offices or walk-in clinics.

“Hospitalizations are the worst of the group, [but] it’s a much bigger pyramid” of people who develop RSV illnesses, Nachman said.

In addition to recommending monoclonal treatment for children under eight months old, the CDC urges parents to get this treatment for vulnerable children who are under two years old.

Dr. Gregson Pigott, commissioner of the Suffolk County Department of Health Services. File photo

Like other vaccinations, the RSV vaccine won’t prevent people from getting sick. It will, however, likely reduce the symptoms and duration of the illness.

“In trials, RSV vaccines significantly reduced lower respiratory tract lung infections serious enough to require medical care,” Dr. Gregson Pigott, Suffolk County Health Commissioner, explained in an email.

At its worst, the symptoms of RSV — such as fever, cough and serious respiratory illness — are problematic enough that it’s worth putting out extra effort to receive some immune protection.

“If you’re a little kid or an elderly patient, this is a disease you don’t want to get,” Nachman said.

Pigott said that data analysis shows that RSV vaccines are 85% effective against severe symptoms of the virus.

While people can receive the COVID-19 and flu vaccines simultaneously, doctors recommend getting the RSV vaccine two weeks later.

According to preliminary data, eligible residents may benefit from the RSV vaccine for two seasons, which means they would likely need to receive the shot every other year, according to Pigott.

With two vaccines approved for adults, Pigott recommended that people receive whichever shot is available.

“Both reduce a person’s chances of getting very serious lung infections,” Pigott explained, adding that several measures can help people protect themselves from the flu, RSV and COVID.

Getting a vaccine, washing hands, avoiding touching your eyes, nose or mouth, avoiding close contact with people who are sick with respiratory symptoms and wearing a mask in places where respiratory viruses are circulating can all help.

Those who are symptomatic should stay home when they are sick and wear masks when they are around other people.

Suffolk County Department of Health Services officials indicated they are aware of the challenges of getting shots and monoclonal antibodies and “ask people to be patient.”

Stock photo

After a November and December in which realities like a “tridemic” of viral threats sickened residents throughout Suffolk County, the new year has started off with fewer illnesses and cautious optimism among health care professionals.

“The numbers are coming down now,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. The overall threat is “less” and “we’re in the take-a-deep-breath phase.”

Indeed, the frequency of cases of several viruses is lower.

“Flu and RSV (respiratory syncytial virus) are down,” Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, explained in an email.

At the Catholic Health hospitals, including Port Jefferson-based St. Charles and Smithtown-based St. Catherine of Siena Hospital, the emergency room visits are down around 10% from a few weeks ago, said Dr. Jeffrey Wheeler, medical director of the Emergency Department at St. Charles.

In between too busy and too quiet, the hospital is in the “sweet spot” where health care providers have enough to do without frantically racing from one emergency to another, Wheeler said.

Among those visiting St. Charles, Wheeler added that health care providers are seeing a smattering of illnesses.

At the same time, the vaccine for the flu has proven to be a “good match” for the current strain, Nachman said. “Amongst those who did the flu shot, they have tended to not get sick enough to go to the doctor.”

According to New York State Department of Health figures, the overall numbers across the state have been declining for the flu. For the week ending Jan. 14, the number of infections was cut in half.

Suffolk County saw a slightly larger drop, falling 59% for the same week, to 571.

This year, people who were going to get the flu vaccine may have helped themselves and their families by getting the shot earlier, rather than dragging out the process of boosting their immune systems over the course of months. Nachman said.

Cases of monkeypox continue to be on the lower side, in part because of the number of vaccines people in the area have received.

To be sure, health care workers are still helping people overcome a range of infections circulating in the county.

“We are still seeing a smorgasbord of flu, COVID and RSV,” said Nachman. Of the people admitted to Stony Brook Hospital, most of them have a comorbidity.

At Huntington Hospital, admissions are “high,” and the hospital census remains high, Popp added.

Health care workers are diagnosing viruses like the flu and COVID-19 and have used available treatments to reduce the symptoms and the spread of these viruses.

New COVID vaccine approach

Earlier this week, the Food and Drug Administration posted documents online that reflected a possible future change in its approach to COVID-19 vaccinations.

Instead of recommending bivalent boosters or a range of ongoing vaccinations to provide protection against circulating strains, the FDA plans to approach COVID-19 vaccinations in the same way as the flu.

Each year, people who are otherwise healthy and may not have high risks may get a single dose of a vaccine based on the strains the administration anticipates may circulate, particularly during the colder winter months.

Health care professionals welcomed this approach.

Nachman and Popp thought a single shot would be “great” and appreciated how the annual vaccine would simplify the process while reducing inoculation fatigue.

“The simplest messages with the simplest strategy often wins,” Nachman said.

Bivalent booster concern

Addressing concerns raised by the Centers for Disease Control and Prevention about a potential link between the bivalent booster and stroke, Nachman suggested that was one data point among many.

Israel has used the Pfizer bivalent booster exclusively and hasn’t seen any such evidence linking the booster to stroke.

The CDC data is “one of multiple data points that we use to look at safety events,” she said. “Not a single other one has shown any relationship with stroke among the elderly in the first 21 days.”

People are waiting once again for COVID-19 and other tests at local urgent care centers. File photo by Lina Weingarten

Around this time of year, parking lots are often full.

That’s true of the mall parking lot, as people go out to shop for holiday gifts for their friends and family, but it’s also true, especially this year, for hospitals and urgent care centers.

With the so-called “tridemic,” which is a combination of viruses that typically affect the lungs, including COVID-19, the flu and respiratory syncytial virus (or RSV), infecting people of all ages, the need for health care and medical attention has been high in the weeks leading up to the holidays.

When Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital, arrives at work at 7 a.m., she drives past urgent center parking lots that are “full for a reason. It’s because people are sick” and need medical attention at the start of the day.

Indeed, the combination of the three viruses, as well as other viruses and bacteria in the community such as adenovirus and enterovirus, has made it difficult for some children to attend schools and for adults to go to work.

For the week ending Dec. 10, which is the most recent period for which data is available, Suffolk County reported 3,936 cases of the flu, which is up 35% just from the prior week. The week ending Dec. 10 alone represents more than half of all flu cases for the entire 2019-2020 season, according to data from the New York State Department of Health.

At the same time, COVID and RSV numbers have climbed.

“We almost doubled our COVID census over the last three to four weeks,” Dr. Michael Khlat, chief medical officer at St. Catherine of Siena Hospital in Smithtown, explained in an email. St. Catherine currently has almost 60 COVID-positive patients. Nearly a third of those patients are admitted for COVID and are receiving intravenous remdesivir, while the others are incidental findings in the context of other medical needs.

“What is special about this surge is that it is inclusive of COVID, influenza, rhinovirus as well as RSV,” Khlat wrote. “The symptoms are very similar, and treatments are all supportive at this time.”

Family gatherings at Thanksgiving contributed to the increase, adding “extra turbocharging to the current respiratory viruses,” Nachman said.

The most vulnerable patients are the immunocompromised, patients with diabetes, chronic lung and cardiac disease, obese residents and patients with chronic liver and kidney disease, Khlat added.

Demand for beds

The influx of patients has meant that St. Catherine has had to increase its capacity of staffing using nursing agencies to meet the needs of the community for “seamless, high-quality care,” Khlat explained.

St. Catherine has also added more providers on the medical wards to care for patients and has load balanced patients with their Catholic services partner St. Charles Hospital and other Catholic Health facilities.

Nachman urged residents to see their primary care doctor if they have routine viral symptoms. Coming directly to the emergency room slows the process of delivering urgent care.

To be sure, Nachman urged anyone with chest pains or stroke-like symptoms should head directly to the emergency room.

Nachman said Stony Brook Children’s Hospital is transitioning to a model in which they triage patients who walk into the ER to assess the need for services.

As people prepare for family gatherings, Nachman suggested that they evaluate the risks of interacting with others.

People with an immune deficiency might want to wear masks or speak outside with others, particularly if someone in the group had one of the respiratory viruses.

Viruses like RSV are generally contagious for about three to eight days, according to the Centers for Disease Control and Prevention.

RSV spreads through close contact, which means that passing someone in a supermarket won’t likely spread the virus, while sitting and doing homework or eating a meal next to someone could.

As for COVID, Nachman continued to urge people to get the bivalent booster shot.

Every study, she said, shows that the booster drastically reduces the risk of being hospitalized with COVID.