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RSV-vaccination

Question
Our daughter, (CF, 1,5 years) was immunized last year against the RS-virus. Since this winter we expect the health insurance to decline an immunisation (for financial reasons) we would like to know from you how important you think this vaccination is (so far she does very well), because we think of accepting the costs ourselves.

Answer
Dear parents,

I would like to answer your question if there is any sense in an RSV-vaccination for your 1.5 years old daughter as follows:
RS-Viruses are the most frequent agents for infections in the lower airways of infants and small children. In our region they occur particularly often from September to March.

An antiviral therapy, that is drugs which in case of an infection of RS-viruses fight these, does not exist yet nor does a so-called active vaccine which stimulates the patient’s immunosystem to produce defence cells and antibodies, which prevent an infection in case of a viral attack.

Thus only the passive vaccination is left that is the intramuscular administration of antibodies against RS-Viruses. This kind of vaccination, however, has not been approved in connection with CF patients, thus the health insurances need not pay it.

If this kind of vaccination causes a decrease of VS-infections in a CF patient’s first two years has not been sufficiently investigated. A study published in February 2008 (Ped Pulmonol 2008, 43: 169-174) showed merely that children younger than 18 months and vaccinated against RSV were hospitalized a reduced number of days– but this was not statistically significant. Therefore you cannot deduce from this study that all children younger than 18 months would benefit by such a treatment. To what extent CF children older than 18 months profit by a passive CF vaccination has hitherto not been investigated.

It is beyond controversy, however, that all CF children older that 5 months and the family members living with them should be actively vaccinated against influenza (Flu shot).

With kind regards,
Dr. E. Rietschel
05.01.2009