RSV jab. To do, or not to do?

[Foxylass]

I hope this is the right place to ask.
My daughter in law (sons partner) and my daughter are both pregnant. The babies will be the first grandchildren in our family.

They have both been offered the RSV jab and are unsure about it. They are not anti-vaxers, they've both had other jabs.

They both look to me for advice, but it is so long since I was pregnant, and much has changed.

I've looked it up online, and to be honest, I am not much wiser.

I think actual experience would be great to learn from, to some extent. So I am looking to you for advice please?

Both 'mums' are UK based, neither smoke, both healthy, aged early 30's and late 20's (if any of that is useful).

I think the worry is, that it seems to be a fairly recent addition to the vax programmes and for a while it was banned.

Thank you in advance.

They have both had advice from their midwives, but there is always value in looking into things deeper.

There really isn't. Most people don't have the knowledge or skills to be able to understand clinical research or data. As you found out when you tried to Google it.

Thank you. We realise it is to protect the babies, I mentioned non-smokers in case it was relevant.
They are also inclined to believe it is safe, but there is no harm in asking for other views.

@RissiOne I am so sorry.
My question was not intended to cause upset, just to gain more information.

DS2 was hospitalised with bronchiolitis when he was a week old. It stared a pattern of repeated hospital admissions, requiring oxygen, he got pneumonia then ended up a severe asthmatic.

I now have a 10mth old DGS, who is DS2’s baby, who has been hospitalised with bronchiolitis twice since the middle of September. The last time he was blue lighted to hospital and ended up on HDU. The RSV vaccine wasn’t available when DDIL was pregnant otherwise she’d have had it.

Bronchiolitis is no joke. I wish there was a vaccine when I was pregnant.

Unlike some previous posters I’ve never know a baby to get very sick with RSV so I’ve been more interested in the risk of vaccination to the mother.

The risk category for Guillain-Barre according to the patient insert is Rare - 1 in 1000. In my opinion this is too high and there have been concerns re other brand RSV jabs also having this side effect so it’s unlikely to just be a rogue trial data error.

Just another to add - my baby was 5 weeks old when she had it. Truly the most terrifying time in my life, she was so so unwell. 100% have the vaccine.

My son was hospitalised for a combination of adenovirus and sleep apnea when he was 3 and had to be on oxygen. Most of the other children on the ward and on oxygen were there with RSV, and I remember speaking to several parents saying they had been in hospital 5+ times that year with recurring infections- it was only June!

I agree that posters should try and be kind, the OP is just looking for advice. I agree it is worrying that there is so much distrust in vaccines these days. Many people don't realise vaccines for pregnant women have very high safety thresholds before they are rolled out. I am pregnant and have just booked in my RSV vaccine for when I'm 32 weeks.

who better to ask than mum or mum-in-law?

Healthcare professionals. Scientists.

While the symptoms are mild for many, RSV accounts for around 30,000 hospitalisations of children under 5 in the UK annually, and for 20 to 30 infant deaths.

It's also worth noting that:

Most cases of bronchiolitis are caused by the respiratory syncytial virus (RSV)

And there's plenty of research which shows a correlation between being hospitalised before the age of 1 with bronchiolitis and needing further intervention with inhalers, oxygen etc to the age of 5.

I wouldn't think twice about getting it, as anyone who has worked in paeds especially over winter will know, it can be so harmful to babies and impossible really to protect them from in day to day life.

I also don’t get why that they’re both bone smokers keeps getting brought up? Surely that’s an absolute given this day and age for a pregnant woman and is the bare minimum you should be when carrying a baby.

Obviously some people do still smoke in pregnancy.

You can also get Guillain-Barré syndrome from just being ill with a virus, it’s actually less likely to occur as a result of having a vaccine

Wow, I really don’t think you understand this risk category.

It’s to protect the babies. Between 20 to 30 babies die each year in the UK from it. And 30,000 children in the UK are hospitalised by it each year. These are averages and there has been an increased with the number of children catching it since covid.

I think post Covid, the rates of both RSV and whooping cough have increased so significantly, to me the current benefits of both jabs during pregnancy far far outweigh any potential risks.

it would appear neither do you!!

No sensible parents should ever have to question this - it's a no brainer. Who on earth would want to risk their child being hospitalised wjth RSV and potentially suffer the after effects for years to come, when there's an option to reduce that risk??

Yeah you don't understand this. This is why you shouldn't assume you know better than researchers and medical professionals unless you're a trained expert in that area. Every research study conducted recently has demonstrated the benefits of the vaccine outweigh the very very small increased risk of GBS, hence the recommendation you take it. Vaccines are not a conspiracy. Just take the jab.

I just checked the PIL and the wording is 'may affect up to 1 in 1000', which is more nuanced. The next risk category is 1 in 10000, therefore the 1 in 1000 includes anything from 1 in 9999 upwards. Also, this is trial data where small fluctuations in rare events can have a large effect on risk calculations due to trial population size.

Post-marketing data from the US on the over 60s, who are already at higher risk of Guillain Barre due to age, indicates 4.4 cases per million doses. This is likely higher than the general population incidence and therefore it is likely that the vaccine does increase the risk, but I would interpret the data as suggesting a considerably lower risk than 1 in 1000. Given the potential impact of RSV it's a risk I'd be willing to take.

The 1in 1000 risk category this is grouped as is 1 in 101 to 1000. Not 1 in 1000 to 9999 as you assert. I already said it was based on horrid trial data. That would be enough to put most people off but apparently not you. Good luck.

My pregnancy days are long gone but no, not a chance.

It was never banned - it just wasn't widely offered. My own premmie children were given the vaccines routinely. My premmie son actually contracted it while in nicu and almost died from RSV. (They are 12 now so definitely not a new vaccine)

RSV accounts for around 30,000 hospitalisations of children under 5 in the UK annually, and for 20 to 30 infant deaths.

How will you feel if you advise them against getting the vaccine and one of their babies becomes dangerously and entirely avoidably ill with RSV?

@5byfive cool. Thanks for confirming there is no reason for you to be on this thread, and that you're just an anti-vaxer who enjoys spreading misinformation and putting babies health at risk.

You're wrong. The clue is in the words 'up to' - this means that 1 in 1000 is the highest risk in the category. https://bnf.nice.org.uk/medicines-guidance/adverse-reactions-to-drugs/