Commentary

Once proven, RSV preventions should be in child immunization schedule

(Photo by Sarah Chai from Pexels)

The United States is making progress against the COVID-19 pandemic, with over 65% of Americans receiving at least one-shot, because of the Biden administration’s laudable efforts to ensure the availability of vaccines to everyone regardless of their income or insurance coverage and a focused effort to reach out to communities hit hardest by the virus. Just as prioritizing equity has been a crucial element in the fight against COVID-19, promoting equitable immunization against other viruses will be the key to keeping America healthy going forward.

Earlier this year, the Centers for Disease Control and Prevention (CDC) issued a Health Advisory Network warning about a surge in cases of respiratory syncytial virus (RSV), a highly contagious respiratory disease among infants that can cause deadly complications such as pneumonia and bronchiolitis (inflammation of small lung airways).  Despite sending approximately 500,000 children under five to the emergency room each year, RSV is often dismissed as a harmless childhood illness. One father whose infant was hospitalized for five days this spring with RSV told Good Morning America that “RSV was never on my radar because when our oldest child had it, it was just treated and wasn’t a big deal.” 

Scientists and doctors are developing new products that hold the promise to prevent RSV in all infants, but in order to distribute RSV immunizations equitably, these new products need to be part of the CDC’s recommended childhood immunization schedule and covered by the federal Vaccines for Children Program (VFC). While some of the immunizations in development use new techniques involving monoclonal antibodies to deliver protection against RSV, any product that produces the high level of resistance from severe disease should be treated like any other immunization. For this reason, we are asking the CDC to include preventative products against RSV to be included in the VFC program if the science shows that they provide protection from severe disease and hospitalization.  

VFC covers the more than 40 million children who are uninsured, underinsured, or eligible for Medicaid; more than half of all children in the U.S. receive their childhood immunizations through VFC. According to the CDC, the Vaccines For Children (VFC) program is a federally funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay. It has been shown to be effective in narrowing racial and income disparities in childhood immunizations; according to analysis by Avalere Health, the VFC program is responsible for an average 23.6% increase in childhood immunizations across populations. Children on Medicaid and Native American children, who are at a disproportionately high risk of severe RSV, often rely on VFC for their shots.

In order for RSV immunizations to be added to the VFC program, the Director of the CDC and the Secretary of Health and Human Services must approve their addition and notify the public through publication in the CDC’s Morbidity and Mortality Weekly Report. While this will take time, now is the moment to start. Nevada is already seeing an uptick in cases just in the past 2 months. According to CDC RSV surveillance, positive tests have increased from .5% in early August to nearly 4% this week – and the peak of RSV infections is not supposed to arrive until January or February of next year. As Dr. Keith Campbell, Associate Chief Medical Officer at Sunrise Children’s Hospital and Sunrise Medical Center, said in a recent interview, “RSV probably is to most children, especially infants… it is a more dangerous disease probably than COVID in many cases.”

We applaud the Biden administration’s effort in ensuring equitable access and delivery of the COVID-19 vaccine. Without their thorough planning and community outreach efforts, COVID-19 infection and death rates would be even worse than what the Delta variant has produced. We need to continue to distribute all immunizations equitably and ensure that infants’ protection from viruses like RSV does not depend on their parents’ ability to pay for immunizations out-of-pocket. If medical experts find that products to prevent RSV save lives, then they belong on the CDC’s recommended immunization schedule and the Vaccines for Children program, plain and simple. The Biden administration, and in particular Health and Human Services Secretary Xavier Becerra, has the opportunity to offer all children protection from RSV; we hope that they take this moment to listen to the scientific and medical experts and continue their efforts on promoting equitable vaccine distribution.

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Sandra Jauregui
Sandra Jauregui

Nevada Democratic Assemblywoman representing District 41 in Clark County

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Tiffany Tyler-Garner
Tiffany Tyler-Garner

Executive Director, Children's Advocacy Alliance

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