My mother called me from the pharmacy last fall. "Jessy, is this something I need to get? I saw it at the counter, but I haven't heard anything about it." [CIDRAP] 

She was talking about the RSV (respiratory syncytial virus) vaccine. She is in her seventies, immunocompetent, and has a daughter with a doctorate in public health. If anyone in the country should have heard about the vaccine by now, it is my mother. And yet there she was in the CVS aisle, calling me to ask if she should get it.

Canva image 

From the looks of the data, she isn't an outlier.

The three respiratory virus vaccines we now have all face barriers, and the barriers are not the same. The flu vaccine fights "it's just the flu," and a recurring suspicion that it's not worth the trouble because its effectiveness varies year to year, depending on how well it matches circulating strains. (For the record: even a moderately matched flu vaccine running at 40% is meaningfully better than zero.) The COVID vaccine fights distrust, much of it inherited from a rollout that looked rushed because the vaccine trials ran in parallel rather than sequentially, even though the rigor was the same

Widespread unawareness

The RSV vaccine is different. It does not have a reputation problem or a trust problem. It has an awareness problem. Most people do not know what RSV is, do not know they are at risk, and do not know there is something they can do about it. It is the middle child of respiratory season, the one we keep forgetting is in the room.

In a recent international survey of adults 50 and older across four countries, only 40% had heard of RSV. In the US, a survey of adults 60 and older and adults with chronic heart, lung, or metabolic conditions found that only 43% had heard of RSV, and among those who had, only about a third felt they knew much about the disease. Numbers like these would be unthinkable for the other two.

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