Respiratory syncytial virus (RSV) is no big deal for most people.
When infected with RSV, many people experience typical cold symptoms — runny nose, congestion, dry cough — for several days. Then it’s over.
However, if you have asthma, chronic obstructive pulmonary disease (COPD) or another lung disease, an RSV infection can be life-threatening, says Abinash Virk, M.D., an infectious disease expert with Mayo Clinic.
Younger people with more effective immune systems typically fend off RSV in the upper respiratory tract — which includes the nose, mouth, throat and voice box. However, in people with already-damaged lungs, such as those with chronic lung diseases like COPD, the virus can cause additional damage — especially in the lower parts of the lung. If the infection affects the small bronchial tubes that lead to the lower parts of the lungs, these tissues become inflamed and cause a condition known as bronchiolitis. If RSV infection spreads to the tiny air sacs in the lungs, called alveoli, you end up with pneumonia.
These delicate lung tissues are already highly sensitive and inflamed in people with asthma. An RSV infection can intensify the swelling and mucus production, narrowing airways, and making breathing even more difficult. RSV also can scar the lung, worsening asthma long after recovery from the infection.
Similarly, in people with COPD, an RSV infection can intensify lung tissue damage, inflammation and irritation.
“Because their lung function is already compromised, they don’t have the ability to deal with another injury to the lung,” says Dr. Virk. “People with advanced lung disease are more likely to be hospitalized with RSV. They may need to be on a ventilator. Some may even die from the infection.”
According to the Centers for Disease Control and Prevention (CDC) estimates, each year RSV leads to between 60,000 and 160,000 hospitalizations and 6,000 to 10,000 deaths in older adults.
Yet new vaccines are available that help prevent serious disease from RSV. Below you’ll find answers to questions people with lung disease may ask about the vaccine.
Should people with lung disease get the RSV vaccine?
In 2023, the Food and Drug Administration approved two RSV vaccines, Abrysvo (Pfizer) and Arexvy (GSK), for people 60 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 obstructive pulmonary disease, asthma, any chronic respiratory or pulmonary disease, diabetes, advanced liver or kidney disease, and chronic heart failure.
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: lung disease, heart 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.
Will the RSV vaccine worsen existing breathing problems?
“It’s not a live virus, so the vaccine can’t give you RSV,” says Dr. Virk. Overall, vaccine adverse effects are limited and do not cause an increase in breathing problems.
Instead, the vaccine helps your body fight off RSV faster and more effectively. The most commonly reported vaccine side effects include injection site pain, fatigue, muscle pain, headache and joint pains.
“The vaccine is much safer than getting RSV,” explains Dr. Virk.
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.
How should I fit it in with other vaccines?
The CDC recommends that people with lung 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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