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As US officials move to restrict vaccines, including the shots to prevent respiratory syncytial virus (RSV), more evidence is emerging to confirm how dramatically the jabs reduce hospitalizations.<\/p>\n
Announced last week as part of new restrictions<\/a> on one-third of all routine childhood vaccines, RSV shots are now recommended only for high-risk babies, instead of all infants. The Trump administration announcement was led by prominent vaccine critic and health secretary Robert F Kennedy Jr.<\/p>\n The UK, Australia, and Denmark<\/a> only recommend the RSV shot for high-risk newborns because those countries all recommend the vaccine during pregnancy. Additionally, those countries have universal healthcare \u2013 which the US does not \u2013 which means everyone is able to visit the doctor regularly and receive the vaccines. In the US, where care is much more fragmented, only about a third of pregnant people receive the shot, according<\/a> to the US Centers for Disease Control and Prevention (CDC).<\/p>\n Infections and hospitalizations from the virus, which is particularly dangerous for young children, are beginning to ramp up in the US this respiratory season. But in recent years, doctors and parents have seen a major decrease in severe illness among babies who received the shots.<\/p>\n \u201cIt\u2019s easy to see in real life. We can really tell that hospitalizations are down,\u201d said Richard Rupp, professor in pediatrics at the University of Texas Medical Branch and the interim director of the Sealy Institute for Vaccine Sciences, who as a researcher was involved with the trials of RSV shots for newborns. \u201cIt\u2019s made a big difference.\u201d<\/p>\n Four studies in Jama confirm these observations, echoing previous data<\/a> showing a significant decline in hospitalization because of the shots.<\/p>\n This time of year, hospitals used be full of babies struggling to breathe because of RSV; sometimes, they would run out of beds for all of them. Doctors like Rupp are now worried restricting the shots will make RSV hospitalizations surge once more.<\/p>\n The vast majority (81%) of babies hospitalized with RSV have no underlying conditions. Giving the shot only to children with existing health issues will \u201cmiss a large majority of the potential cases\u201d, says Kevin Ault, an obstetrician-gynecologist and a member of the now-defunct<\/a> RSV working group at the Advisory Committee on Immunization Practices (ACIP).<\/p>\n \u201cThat\u2019s very concerning, and that\u2019s why a universal recommendation was made,\u201d he said.<\/p>\n Rupp called RSV \u201ca horrible disease\u201d and described how it can manifest in a patient: \u201cAt first, it might seem like a child has a little cold, but then things can change \u2013 and quickly. In an hour or two, it can turn the other way,\u201d with the child \u201cfighting for every breath \u2026 The fear is always that they\u2019ll just stop.\u201d<\/p>\n RSV vaccination during pregnancy is 70% effective at preventing hospitalization, and the shot given to newborns to prevent RSV was even better, at 81% effective, one study found<\/a>. The newborn shot is more effective at preventing child hospitalization compared to the pregnancy shot, though both worked well, according<\/a> to a second study.<\/p>\n Notably, the RSV shot for infants appears to prevent hospitalization from all lower-respiratory infections, a third study found<\/a>. That\u2019s likely because RSV can cause lingering effects, such as bacterial infections. And the vaccines are safe to give during pregnancy, a fourth study found<\/a>. In the clinical trials, there was a statistically insignificant possibility of preterm birth, but this follow-up study found no such relationship.<\/p>\n Prior to the shots, which were approved in 2023, 2 to 3% of babies in the US were hospitalized with RSV.<\/p>\n \u201cIt\u2019s the most common reason for children under five to be hospitalized,\u201d said Ault. RSV has also been linked with developing asthma, a lifelong condition that can be dangerous.<\/p>\n The shots given to infants aren\u2019t typical vaccines; they are monoclonal antibodies, or lab-made antibodies that help the babies fight off the virus for several months, until the protection fades.<\/p>\n Experts were surprised when the Trump administration began targeting the shots.<\/p>\n \u201cI was caught, I\u2019ve got to say, flat-footed on the whole RSV thing,\u201d Rupp said. \u201cI was surprised, because this sort of seems like an attack on monoclonal antibodies.\u201d<\/p>\n With Covid, even people who were opposed to vaccination have been eager<\/a> to get the monoclonal antibody treatments, Rupp pointed out. Earlier versions of monoclonal antibodies to fight RSV have been given to children for decades without any safety signals emerging.<\/p>\n \u201cI could not even imagine that we would be at this spot with anybody even doubting that it was something that should be available for all the kids,\u201d Rupp said.<\/p>\n Ault said the decision was \u201cmade by political appointees without a scientific basis\u201d.<\/p>\n Tracy Beth H\u00f8eg, who was recently named the top drugs regulator at the US Food and Drug Administration (FDA), claimed recently<\/a> that babies in the clinical trials had a higher death rate \u2013 but she also noted that it was not statistically significant. Even so, the FDA launched an investigation<\/a> into the safety of the shots.<\/p>\n