The Centers for Disease Control and Prevention (CDC) advisory panel recently voted in favor of making the first vaccines for respiratory illness RSV available to older adults aged 60 and over. This decision follows the FDA’s approval earlier this year of GSK’s Arexvy and Pfizer’s Abrysvo vaccines for RSV prevention.
While doctors and vaccine manufacturers are not obligated to follow the CDC panel’s recommendations, these votes ultimately determine federal requirements for insurance coverage of vaccinations.
The panel’s guidance falls short of a full recommendation for all eligible older adults to receive the vaccines. Instead, it calls for “shared clinical decision-making” between doctors and patients to assess whether the benefits outweigh the risks on an individual basis.
Seniors in their early 60s face a lower risk of severe RSV illness compared to their older peers. Additionally, a few cases of severe “inflammatory neurologic events” were reported in vaccine trials, further complicating the risk-benefit analysis.
Assessing the rarity of potential side effects will require post-vaccination studies analyzing large health record databases. The CDC assures that they will closely monitor data from their vaccine safety systems for the launch of the new RSV vaccines.
Vaccine manufacturers are still determining when seniors may require booster doses of the RSV vaccine in the future. Additionally, the final pricing of the vaccines remains undecided, creating challenges for broader recommendations.
GSK suggests a price range of $200 to $295 per dose, while Pfizer estimates $180 to $270. Concerns about cost-effectiveness arise at higher prices, especially for younger individuals eligible for vaccination.
While delaying the vote was suggested to await finalized prices from each manufacturer, swift action is crucial to protect the most vulnerable populations from RSV. Vaccines are most effective when administered before infection rates rise, as witnessed last year.
Dr. Camille Kotton, chair of the committee’s work group, emphasizes the importance of timely decision-making to save lives and prevent hospitalizations in the current year. Ongoing studies and the development of new vaccines are expected to bring more understanding of RSV in the coming years.
Later this year, the FDA is anticipated to decide on new vaccines for protecting infants from RSV, which will eventually be evaluated by the ACIP as well. The field of RSV prevention is likely to evolve in the next five to ten years, prompting ongoing reassessment.
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