Vaccination during pregnancy: Should you get the maternal RSV vaccine?

Evan Walker
Evan Walker TheMediTary.Com |
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The maternal RSV vaccine helps protect the unborn child from severe illness from birth through the first 6 months of life. Bloomberg Creative/Getty Images
  • The RSV virus affects about 64 million people around the world each year, causing about 160,000 deaths.
  • RSV may cause severe symptoms, leading to hospitalizations and possible death, in newborn infants and older adults.
  • Health officials recommend pregnant people get Pfizer’s maternal RSV vaccine during the third trimester of pregnancy to protect their baby during the first 6 months of life.

The Centers for Disease Control and Prevention (CDC) recently issued a health advisory alerting healthcare providers about low vaccination rates against influenza, COVID-19, and respiratory syncytial virus (RSV).

The CDC warns that low vaccination rates may lead to more severe disease and increased Healthcare capacity strain during peak respiratory virus season.

RSV is an infection of the lungs and respiratory tract that globally affects about 64 million people every year and causes about 160,000 deaths each year.

For most healthy adults, RSV presents mild symptoms similar to the common cold.

In vulnerable populations — such as newborn infants and older adults 65 years and older — RSV can cause severe symptoms and develop into conditions such as pneumonia and bronchiolitis, potentially leading to hospitalization.

For this reason, the CDC and the American College of Obstetricians and Gynecologists (ACOG) recommend that pregnant mothers receive the maternal RSV vaccine made by Pfizer during the third trimester to pass antibodies to their unborn baby.

Getting the maternal RSV vaccine could help protect infants from severe illness from birth through the first 6 months of life.

Dr. Laura E. Riley, chief OB-GYN at New York-Presbyterian/Weill Cornell Medical Center and chair of the Department of Obstetrics and Gynecology at Weill Cornell Medicine in New York City, told Medical News Today that RSV is dangerous for babies and young children, as it can cause serious respiratory illness.

“In fact, [RSV] is the leading reason infants are hospitalized in the United States,” she said. “We should do everything we can to protect babies from RSV, and that’s why the vaccine is so important.”

Dr. Silvia M. Abularach, an obstetrician-gynecologist affiliated with multiple hospitals in Maryland, including Mercy Medical Center in Baltimore, agreed.

“For the first few weeks of life, infants are not able to mount a vaccination response and immunity and adequate immunity response,” Dr. Abularach explained to MNT.

“So that’s why infants don’t get vaccinated for a couple of months. The first few months of life is the most vulnerable time for these infants.”

“The take-home point is [that RSV] is not going to kill a young mother,” noted Dr. G. Thomas Ruiz, a board-certified OB-GYN and lead OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA. “They’re not going to get very sick — they’re going to get cold-like symptoms and maybe a cough. It doesn’t tend to affect adults.”

“But [RSV] can be a devastating disorder for newborns, leading to hospitalization and death from pneumonia,” Dr. Ruiz continued. “So you’re really [getting] the vaccine to protect your baby.”

The RSV vaccine Abrysvo made by Pfizer Inc. was approved by the Food and Drug Administration (FDA) in August 2023 for use as a maternal vaccine to help protect infants at birth and through the first 6 months of life.

The FDA approval was based on results from the vaccine’s phase 3 clinical trial where no safety signals were detected in either pregnant study participants or the children born after they received the vaccine.

Dr. Ruiz told MNT the RSV vaccine is incredibly safe, and there’s no reason for a pregnant person not to get one unless they are allergic to the vaccine’s carrier medium.

He also said another benefit of the maternal RSV vaccine is that it’s preservative-free.

“Preservative-free means there’s less things within the vaccine that’s going to cause an allergic reaction [for] the mom,” Dr. Ruiz explained.

“(With) the maternal vaccine, they make sure to give them something that is as nonreactive to the body as possible, so the term we use is preservative-free.”

Dr. Triebwasser noted the RSV vaccine is a recombinant antigen vaccine, meaning it’s not a live virus vaccine.

“Some people are hesitant to receive vaccines during pregnancy, although we have a lot of data on older vaccines, including the flu vaccine, that maternal vaccination is safe for the pregnant person and babies. There may be an association between RSV vaccination and preterm birth, although that is not certain. To limit (the) potential risk of preterm birth, the recommendation is to give (the) RSV vaccine at 32–36 weeks.”

— Dr. Jourdan Triebwasser, assistant professor of maternal-fetal medicine

Currently, the only RSV vaccine FDA approved as a maternal vaccine is Pfizer’s Abrysvo vaccine.

The pharmaceutical company GSK plc also makes an RSV vaccine called Arexvy. However, the FDA has only approved it for use in older adults 60 and older.

Dr. Riley advised that pregnant people who want to arm themselves with accurate information on the vaccine they should be taking can talk with a healthcare professional or visit credible websites from organizations and agencies such as the CDC.

“Abrysvo is the only RSV vaccine approved for use in pregnancy,” Riley noted.

“Not all doctors’ offices and pharmacies have Abrysvo yet. Pregnant people can search for pharmacies that have the vaccine on the Abrysvo website,” she added.

Dr. Abularach said a pregnant person can always ask their doctor to confirm which RSV vaccine they should have.

“If they choose to go to a commercial pharmacy like CVS or Walgreens, which have them available now — obviously confirmation there as well — asking the question to make sure that they’re getting the right vaccine,” she added.

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