Last fall, RSV and influenza season arrived early. (The official cold and flu season starts in October of every year). In October of 2022, we were concerned that increasing rates of RSV-associated hospitalizations so early in the traditional cold and flu season portended bad things for December-March, the typical yearly peak period. Instead, RSV levels topped out in November (albeit at historically high levels for kids), influenza maxed out in December (at fairly typical magnitudes), and both fell off quickly and remained relatively quiet for the winter. For its part, Covid peaked right around the New Year for the 3rd consecutive season, followed by a period of much lower prevalence in the spring, which is pretty typical for a seasonal coronavirus.
I think that would depend greatly on the incidence rate of GBS and the severity of the cases. It looks like the GBS rate was around 1 in 10,000 in recipients of the vaccine. Of course the background rate of GBS for RSV could be similar, and the question then becomes whether the vaccine prevents virus-induced GBS. I don't have the answer to that.
The background rate of 65 hospitalizations per 100k in the population above age 65 is pretty substantial (and 100 per 100k in those over age 75). The vaccine would stand to prevent most of those, since it was 94% effective against severe RSV disease.
So you might save 9.4 cases of severe RSV (read: life threatening) per 10,000 with the vaccine for people ages 75+, and possibly have 1 case of GBS per 10,000 as the risk (again, might be lower if unvaccinated RSV also causes GBS more than vaccinated cases, which I do not know).
Based on the above, I'd recommend the vaccine to most people 60+, but certainly there's a question of risk tolerance on both sides of the equation.
Please give us your thoughts about the RSV vaccine for 60+ given the risk for Gillian Barre.
Hi--
I think that would depend greatly on the incidence rate of GBS and the severity of the cases. It looks like the GBS rate was around 1 in 10,000 in recipients of the vaccine. Of course the background rate of GBS for RSV could be similar, and the question then becomes whether the vaccine prevents virus-induced GBS. I don't have the answer to that.
The background rate of 65 hospitalizations per 100k in the population above age 65 is pretty substantial (and 100 per 100k in those over age 75). The vaccine would stand to prevent most of those, since it was 94% effective against severe RSV disease.
So you might save 9.4 cases of severe RSV (read: life threatening) per 10,000 with the vaccine for people ages 75+, and possibly have 1 case of GBS per 10,000 as the risk (again, might be lower if unvaccinated RSV also causes GBS more than vaccinated cases, which I do not know).
Based on the above, I'd recommend the vaccine to most people 60+, but certainly there's a question of risk tolerance on both sides of the equation.
Thank you for your response. It is very helpful and as always based on facts.