While I’m sure that many parents would love to get their kids vaccinated and protected against RSV, unfortunately,
we don’t yet have an actual RSV vaccine.
Update – We actually do have an RSV vaccine now! Abryso is an RSV vaccine approved for seasonal use (September to January) at 32 through 36 weeks gestational age of pregnancy.
We do have Synagis (palivaizumab) though, a monthly injection that can be given to high risk children during RSV season to help prevent them from getting RSV.
Update – an Beyfortus is an RSV monoclonal antibody injection that can be given as a one time dose to all infants who are younger than 8 months and born during, or entering, their first RSV season and high risk children between the ages of 8 and 19 months entering their second RSV season. It will replace Synagis.
Do My Kids Need Synagis?
Synagis is not a vaccine and doesn’t stimulate your body to make antibodies, but is instead an injection of RSV antibodies made by recombinant DNA technology. That’s why you need to get an injection each month. The antibodies don’t last much longer.
So why doesn’t everyone get Synagis if RSV can be such a deadly disease?
For one thing, there is the high cost of Synagis injections, but there is also the fact that Synagis is only approved to be given to kids who are at high risk for severe RSV infections.
“Palivizumab prophylaxis has limited effect on RSV hospitalizations on a population basis, no measurable effect on mortality, and a minimal effect on subsequent wheezing.”
AAP on Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection
And Synagis doesn’t have as a great an effect on preventing RSV infections as we would like. That’s why we need a real RSV vaccine instead.
So because it likely doesn’t provide that much help to kids who aren’t at very high risk for severe disease, the latest guidelines recommend that Synagis be given to:
- pre-term infants born before 29 weeks, 0 days’ gestation and who will be younger than 12 months at the start of the RSV season
- preterm infants with CLD of prematurity, defined as birth at <32 weeks, 0 days’ gestation and a requirement for >21% oxygen for at least 28 days after birth.
- certain infants with hemodynamically significant heart disease during their first year of life and might include infants with cyanotic heart defects, infants with acyanotic heart disease who are receiving medication to control congestive heart failure and will require cardiac surgical procedures and infants with moderate to severe pulmonary hypertension, infants with heart lesions that were corrected by surgery, but who continue to require medications for congestive heart failure, and children under age two years who have had a cardiac transplant.
- certain children in their second year of life if they required at least 28 days of supplemental oxygen after birth and who continue to require medical intervention (supplemental oxygen, chronic corticosteroid, or diuretic therapy)
- certain infants in their first year of life with pulmonary abnormality or neuromuscular disease that impairs the ability to clear secretions from the upper airways
- certain children in their second year of life if they will be profoundly immunocompromised during RSV season
Those who qualify get up to five monthly doses, beginning in November, to help make sure they are covered through the peak of RSV season – December to May.
Whether or not your high risk child gets Synagis, you can help to reduce their risk of getting RSV by making sure they are not exposed to tobacco smoke, keep them away from crowds of people, wash hands often, and if possible, keep them out of day care.
“Some blood products do not contain antibodies that interfere with vaccine replication. Palivizumab (Synagis), used for the prevention of respiratory syncytial virus (RSV) infection in infants and young children, contains antibody directed only at RSV. Washed red blood cells contain a negligible amount of antibody. These products can be given anytime before or after administration of MMR or varicella-containing vaccines.”Pinkbook – General Recommendations on Immunization
There are no contraindications to getting Synagis with other immunizations.
What do you do if your high risk child was denied Synagis by your insurance plan? If your infant has a qualifying condition, your pediatrician should be able to help you write an appeal to your insurance company stating that getting Synagis is a medical necessity.
More on Synagis and RSV Vaccines
- AAP – Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection (policy statement)
- AAP – Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection (technical report)
- AAP – Respiratory Syncytial Virus (RSV)
- AAP – Protecting Your Baby from RSV
- CDC – RSV State Trends
- CDC – RSV Census Regional Trends
- CDC – RSV Transmission and Prevention
- MMWR – Respiratory Syncytial Virus — United States, July 2012–June 2014
- CDC – Pinkbook – General Recommendations on Immunization
- MMWR – General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
- Best practice in the prevention and management of paediatric respiratory syncytial virus infection
- Questions to Ask Your Doctor About RSV
- Clinical Decision Support and Palivizumab
- RSV 101: What Every NICU Parent Needs to Know
- Synagis Support Programs
- Synagis Appeal Support
- 12 Tips for Getting Synagis Injections Approved
- Synagis at GoodRx