Other useful links and further reading:

All the programme guidance so far on GOV.UK

Pfizer's web page on Abryvso - contains some training modules and other key information including guidance for England, Wales, Scotland and Northern Ireland.

Respiratory syncytial virus (RSV): symptoms, transmission, prevention, treatment. The symptoms, means of transmission, best means of prevention and treatment of RSV.

Respiratory syncytial virus (RSV): guidance, data and analysis. These documents provide advice on the symptoms, diagnosis, treatment, management and epidemiology of respiratory syncytial virus.

The UK Health Security Agency (UKHSA) monitors levels of RSV activity in England and publishes information throughout the RSV season (October-March). The epidemiological data are included in UKHSA’s weekly national influenza reports

2024: Interesting conference recordings around RSV

SPC Abrysvo

VIDEO - preparation of Abrysvo - using the vial adaptor - worth a watch!!! this could be a bit fiddly to get the hang of at first

Training resources - slides and all prog documents

The older adults RSV vaccine programme training slide set can be downloaded here. The RSV vaccination of pregnant women for infant protection training slide set can be downloaded here.

I wrote a blog about HCA's and RSV HERE

Information on respiratory syncytial virus (RSV) and the benefits of vaccination for pregnant women and their babies and a poster and stickers to promote the vaccination to pregnant women.

Information on respiratory syncytial virus (RSV) and the benefits of vaccination for adults and resources to promote the vaccination to older adults.

Recent Updates & News

25th March 2025: RSV vaccination is proving to be fruitful! Early data (in the Lancet) from the roll out of the RSV vaccination programme in England shows it is making a significant reduction to hospital admission rates in older people. The findings from UKHSA indicate 30% fewer hospital admissions in 75 to 79 year olds than would have occurred without vaccination. This was seen after around 40% of eligible older people took up the vaccine this winter, and the impact is expected to increase with further vaccine uptake (see the latest uptake data here). Keep going everyone!!

Food for thought: In the latest uptake reports coverage varied significantly by ethnic group, the highest coverage being reported for the ‘Other ethnic groups - Chinese’ category (66.2%) and lowest for the ‘Mixed - White and Black Caribbean’ category (21.5%).

28th Feb 2025: mRESVIA RSV vaccine approved to protect patients aged 60 and over. The MHRA has approved an mRNA respiratory syncytial virus (RSV) vaccine (brand name mRESVIA) to protect patients aged 60 and over against lower respiratory tract disease caused by RSV.

27th Feb 2025: Updated government slidesets

20th Feb 2025: Respiratory syncytial virus (RSV): vaccination for older adults: Added links to translated versions of the RSV guide for older adults. And on the 22nd Feb, more translations appeared for the maternal prog resources (have you checked out the posters and stickers?)

18th Feb 2025: Both the guidance for the Maternal RSV and Older Adults RSV vaccination programmes have been updated to reflect new data on Guillain-Barré syndrome (GBS) a very rare side effect of the Abrysvo vaccine, updated contraindications and information on vaccination of those under 18 who are pregnant. Just for some perspective on this, in vaccines on average the case of GBS occur in roughly 10 cases per million. With Abrysvo, it's about 20 cases per million. Still low risk in general basically!

18th Feb: Respiratory syncytial virus (RSV) vaccination programme: Updated links to training slides.

13th Feb 2025: Fast Five Quiz: Respiratory Syncytial Virus Infection in Adults

6th Feb 2025: The RSV chapter in the Green book has been updated with recent evidence on vaccine safety and effectiveness, and latest JCVI advice on selective immunisation with monoclonal antibodies.

4th Feb 2025: Updates made to all patient-facing materials (see below useful resources links) to include details of the rare side effect Guillain-Barré syndrome

22nd Jan 2025: Interesting read (note: based on American data): RSV Vaccines Will Carry Warning for Guillain-Barré Syndrome

10th Dec 2024: This leaflet for pregnant women has now been updated to include RSV

28th November2024: RSV immunisation for older adults and pregnant women: vaccine coverage in England - updated. This report evaluates vaccine coverage in the catch-up cohorts aged 75 to 79 years old before 1 September 2024 and until 31 August 2025. The key conclusion is that as of 31 October 2024, the overall vaccine coverage in the catch-up cohort (adults aged 75 to 79 before the programme start date) reached 32.6% in October, following the initial 22.6% reported in the September interim report. In addition, this report highlights that coverage varies by nearly 8% between regions and nearly 23% between ethnicities.

21st Nov 2024: More promotional material updates- there's been an update to some of the vaccination in pregnancy leaflets to include RSV. We have hit over 1 million RSV vaccinations administered in just the first two months of the programme. A recent study in the Lancet showed that the RSV vaccination programme could prevent 5,000 hospitalisations and 15,000 A&E attendances for infants – a critical, life-saving step forward to help front line staff prepare for increased winter pressures. The same modelling also suggests that the first season of the older adult’s catch-up programme alone could prevent around 2,500 hospital admissions, 15,000 GP visits and 60,000 RSV illnesses in adults in the older age group.

1st Oct 2024: The RSV Green book Chapter was updated to link to the immunisation programme letters.

4th September 2024: Evidence emerging from America that RSV vaccines have been shown to reduce hospitalisation in the older age groups by 75%. Promising stuff! Meanwhile, some news articles and social media posts may result in the need for important reassuring conversations with pregnant ladies. Get ahead of any queries by knowing the background! Here are some useful articles to browse. Key message: TIMING IS EVERYTHING!

• Perinatal Outcomes After RSV Vaccination During Pregnancy—Addressing Emerging Concerns

• Study details why phase 3 trial of GSK's RSV vaccine for pregnant women was halted early

26th August 2024: RSV is hitting BBC news with some cautionary tales like this article: Mum urges pregnant women to take up RSV vaccine

2nd August 2024 Pretty much everything you need to know has been outlined in the Vaccine Update special RSV edition. I've noticed on a practical level that a lot of people on the update courses are worrying about fridge space as RSV comes in a fairly large box (each single-dose pack measures 73mm x 35mm x 116mm) and Flu vaccines are going to be arriving simultaneously. If this isn't something you have considered yet, take a look at space and think about making provision as soon as you can! Be really careful about ordering. To avoid ordering errors, there are restrictions in place (this is not to do with supply issues which I know some people have also been worrying about). Small and often is the key! ALSO... DON'T FORGET TO RECYCLE!!! A LOT of packaging waste is created in a busy RSV clinic.

12th JULY 2024 The updated Green Book chapter has landed! MORE info added to the government 'information to health care professionals' resources collection 12th July as well: Training slide sets, posters and guides for the programmes.

Keep an eye out for the PGD ... (which has arrived now and can be found here)

SEPT 2024 RSV vaccine programme to commence for pregnant ladies (therefore infants) and older adults 75-79 years old. Some key bits of info: Pregnancy vaccines to be done through maternity services from 28 weeks (and can be right up until birth as can also offer protection through breastmilk- OFF label though if after 36 weeks - check PGD). Pharmacy involvement with adult programme possibly (see article below). Year round offer, disease is seasonal but vaccines don't have to be seasonal due to long efficacy. Excellent efficacy still at 2 years, no recommendations for boosters at this time (although should be given in every pregnancy). A single dose of Abrysvo should be offered to all adults turning 75 years old on or after 1st September 2024 and as a one-off catch-up programme for all adults aged 75-79 years old on 1st September 2024. They remain eligible up to the day before turning 80 years of age. People turning 80 in the first year of the programme will have until 31 August 2025 to get vaccinated. GB recommends that RSV vaccine is not routinely scheduled to be given to an older adult at the same appointment or on the same day as an influenza or COVID-19 vaccine (unless necessary for compliance) but can be given alongside Shingrix and the pneumococcal vaccines. PREGNANT women however - no specific recommendations about leaving intervals. Co-administration of flu COVID and RSV vaccines could attenuate the responses to all and this possibly a greater consideration for those who might respond less well to the vaccines in the first place such as the older age groups.

JUNE 2024 Article about community pharmacy involvement

JUNE 2024 Respiratory syncytial virus (RSV) vaccination programmes letter landed. The letter provides information on the respiratory syncytial virus (RSV) vaccination programmes from 1 September 2024

SEPT 2023 Government thoughts regarding an adult vaccine programme: see JCVI statement. (For older adults, the JCVI advised that GSK’s adjuvanted pre-F vaccine (Arexvy), Pfizer’s Abrysvo or Moderna’s mRNA vaccine would all be suitable for a national programme, but Abrysvo won the tender for the NIP. This is likely because Abrysvo is licenced for use in pregnancy and older adults, whereas GSK's vaccine is only licenced for older adults. Moderna's vaccine doesn't have a UK licence currently).

Webinars

Two webinars for health professionals were run on 9th and 12th July by speakers from NHSE and UKHSA outlining the key information about the September program. One was on the maternal programme and the other on the adults programme. IF YOU MISSED THEM the recordings and slides and other materials can be accessed by emailing externalaffairs@ukhsa.gov.uk (I'm sorry I can't share the link but the email says it's confidential so I must respect that. Can have my website shut down as soon as it's begun!).

Bits and bobs to casually drop into conversation

Did you know....

• RSV infects up to 90% of children within the first 2 years of life and frequently reinfects older children and adults.

• There are roughly 33 million cases, 3.6 million hospital admissions, and 100,000 deaths globally each year from RSV in children under 5 years old. It is the second largest infectious cause of death in children under one year of age, after malaria. Adult infections are often undiagnosed, particularly in the elderly, leading to an underestimated number of cases.

• RSV has been estimated to account for 175,000 annual GP episodes in those age 65 years and older in the UK, and an estimated 5000-7500 deaths in older adults in England and Wales every winter, the vast majority of which occur in adults over 75 years (Green Book)

• Despite developing antibodies after an infection, individuals remain vulnerable to RSV throughout life.

• There are currently NO approved vaccinations for children. Passive immunisation, using a monoclonal antibody (mAb) called Palivizumab (monthly administration) that mimics the immune system’s ability to fight off RSV, is currently used to protect very high risk infants, such as those with severe underlying lung or heart disease, and all children less than 24 months of age with severe combined immunodeficiency syndrome (SCID). A new mAb, called nirsevimab, that could be used widely (and lasts 5 months-ish) has recently been licensed alongside the RSV vaccine for pregnant women (also to passively immunise the child).