FDA approval of historic RSV vaccine offers hope for rural Alaska medical providers

The Food and Drug Administration (FDA) recently approved a new vaccine in the battle against respiratory syncytial virus, or RSV — which may be a major medical advance for many people, especially those living in rural Alaska.

According to the Centers for Disease Control and Prevention (CDC), RSV leads to as many as 160,000 hospitalizations of elderly people in the United States each year.

RSV has been a fact of life for decades in the U.S., and it is the leading cause of respiratory infections in infants and children worldwide. Now, FDA approval of GSK’s Arexvy vaccine for use in adults 60 and older, the first of its kind, has given medical professionals in Alaska new hope for dealing with the virus.

“They've been working on this vaccine since the 1960s,” Fairbanks-based pediatrician and Alaska Department of Health staff physician Mishelle Nace said. “So getting this first vaccine approval by FDA earlier this month was phenomenally like, okay, we are there, we are going to be able to help these people.”

While RSV symptoms for healthy people have been likened to the common cold, the virus can be deadly for the very young and very old, especially premature infants and adults 65 years and older. According to the CDC, there are as many as 10,000 RSV-related deaths among the elderly in the U.S. every year.

Nace said that the new vaccine is only the first step in the fight against RSV.

“From what we learned through COVID, it is easier to test on adults and older people than it is to test on pregnant and infants. So we tend to see these vaccines come out first in that age group,” Nace said. “But in the works, in the pipeline, are also these vaccines for pregnant people as well as infants.”

Yukon-Kuskokwim Health Corporation Chief of Staff Dr. Ellen Hodges said that the potential benefits of the vaccine go beyond preventing severe RSV infections in the elderly.

“There was a period of time when our Elders could be vaccinated against pneumococcal disease and we didn't yet have an approved vaccine for children. And it did start to reduce the rates of pneumococcal disease among children as well,” Hodges said. “So we're hoping that by vaccinating our Elders, we can have a two-fold effect by protecting our Elders against severe disease, but also hopefully protecting our most vulnerable babies as well.”

According to Hodges, the rate of hospitalization for RSV is five times greater among Alaska Native children than for the U.S. as a whole.

“The Y-K Delta has some of the highest rates of severe RSV. There is a book called the Red Book, which is published by the American Academy of Pediatrics, and it's about infectious disease. The Y-K Delta merits a special comment in that book because of our severity and amount of RSV that we have in our region,” Hodges said.

Hodges hopes that Arexvy will be fully approved soon.

“I was actually just talking with the state, and it has a possibility of being approved by the ACIP, which is the Advisory Committee on Immunization Practices for the CDC, as soon as this week,” Hodges said. “So we could potentially be able to order that sometime in the very near future.”

This means that the vaccine could be available in time for roll-out in Alaska and the Y-K Delta in the fall when the first cases of RSV are commonly seen.