Respiratory viruses can affect your heart more than you might expect — and the respiratory syncytial virus (RSV) is no exception.
In healthy people without heart disease, an RSV infection usually feels and progresses like the common cold. Their noses run. They feel congested. They cough, and they might get a fever. After several days, they recover, says Abinash Virk, M.D., an infectious disease expert with Mayo Clinic.
On the other hand, “People with chronic heart disease, such as congestive heart failure, are at a higher risk of having a more severe infection of RSV,” says Dr. Virk.
People with congestive heart failure, for example, have an eightfold higher risk of being hospitalized for RSV than do those without congestive heart failure.
That’s partially because the RSV infection leads to increased burden on the heart as a result of the inflammation in the lungs. The RSV virus inflames tissues even more, leading to more severe cardiac symptoms. As your body fights off RSV, blood pressure rises, blood clots become more likely, and the heart muscle can swell or become scarred.
RSV also can migrate to the lower respiratory tract, leading to pneumonia or bronchiolitis, an inflammation of the small airway passages that lead to the lungs. These conditions can bring on intense symptoms like a severe cough, rapid breathing and difficulty breathing. They also can bring on wheezing, a high-pitched noise usually heard on the exhale.
“People with heart disease — especially congestive heart failure — are already taxing their lung and cardiac reserves. RSV then taxes these organs even more,” says Dr. Virk.
Even after the RSV infection clears up, your lungs will likely need time to recover. On top of that, lung infections can strain the heart and surrounding blood vessels, making you vulnerable to future heart problems. These can include high blood pressure, heart failure or a heart attack, which is also known as myocardial infarction.
Yet new vaccines are available that help prevent serious disease from RSV. Below you’ll find answers to questions people with heart disease may ask about the RSV vaccine.
Should people with heart disease get the RSV vaccine?
In 2023, the Food and Drug Administration (FDA) approved two RSV vaccines, Abrysvo (Pfizer) and Arexvy (GSK), for people 60 years and older. Abrysvo was also approved for use in pregnant people. Both vaccines use altered RSV protein to stop the virus from attaching to respiratory cells.
A study of almost 25,000 people found that the GSK vaccine (Arexvy) was 82.6% effective in preventing lower respiratory tract RSV disease in adults 60 years of age and older. It was 94.6% effective in those with one or more of the following conditions: chronic heart failure, chronic obstructive pulmonary disease, asthma, any chronic respiratory or pulmonary disease, diabetes, and advanced liver or kidney disease.
A study of over 34,000 people found that the Pfizer vaccine (Abrysvo) was 66.7% effective in preventing a lower respiratory tract RSV disease with two or more signs and symptoms and 85.7% effective in preventing disease with three or more signs and symptoms in adults 60 years of age and older. It was 75% effective in preventing disease with three or more symptoms in those with one or more of the following conditions: heart disease, lung disease, liver disease, kidney disease, diabetes and tobacco use.
The efficacy rates of the two vaccines are not directly comparable because the studies used different illness definitions.
Is the RSV vaccine safe for people with heart disease?
Some people with heart disease worry about vaccines leading to conditions like myocarditis, an inflammation of the heart wall. These fears may stem from news accounts that have linked the mRNA COVID-19 vaccines (Moderna, Pfizer-BioNTech) with myocarditis in teenagers, though the side effect is extremely rare, according to the CDC.
The RSV vaccine and COVID-19 vaccines are made differently. The RSV vaccine is not an mRNA vaccine, and no cases of myocarditis were reported in clinical trials.
When is the best time to get the vaccine?
Talk to your healthcare team about getting the vaccine in the early fall, before RSV and other viruses tend to circulate.
Is it safe to get the RSV vaccine with other vaccines?
The CDC recommends that people with heart disease receive the influenza, COVID-19 and pneumococcal vaccines. For convenience, you may be able to get several vaccines during the same visit. However, it’s also OK to receive only one shot at a time if that’s what you prefer. Talk to your healthcare team to come up with the best vaccination plan for you.
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