As a pediatrician, I deal with both RSV and flu a LOT, and Saint asked me to comment on this thread...
1.) RSV severity varies widely. Young children, particularly premature infants, can have life-threatening respiratory distress. Other children will be spared the bad breathing difficulty, but have miserable cough and cold symptoms for several weeks. Other children will have nothing more than regular cold symptoms. Adults and older children can easily have RSV and never know it-- adults with "colds" can end up infecting their infants, who then have much more serious disease. However, even if it was your cold that resulted in your child's RSV infection, there is little point in beating yourself up about it. RSV, and cold viruses, are REALLY good at what they do. They spread VERY easily. If they didn't, they wouldn't still be around!
2.) There is no point in purposefully exposing someone to RSV to "build up their immunity". First of all, it is the youngest infants who are most endangered by the virus-- deliberately exposing them to the virus is a very inadvisable game of Russian Roulette. Second of all, having RSV disease does not make you immune to further infection. Babies can and do have multiple RSV infections, sometimes even more than once in the same season.
3.) There is not actually a vaccine for RSV. A vaccine works by introducing your body to a part of a germ, or something similar to the germ, to teach your immune system how to produce antibodies to fight that germ if it is encountered again. Once your immune system learns how to make those antibodies, it can (in most cases) produce them whenever needed later on. What we have for RSV is different-- we basically provide the body with ready-made antibodies that circulate for a while and provide protection while they last, but eventually the antibodies wear out and go away, leaving you vulnerable again. Getting a vaccine is the equivalent of learning how to fish. Once you learn how, you can feed yourself. Synagis, the "RSV shot", is the equivalent of being handed the fish already caught. When it's gone, you're hungry again. To protect a baby from RSV, you have to give the Synagis shots once a month throughout the RSV season-- usually five months total. This is hideously expensive. While no one wants their child to suffer from RSV, the expense is really only justifiable in very high-risk children-- premature infants, and some others with heart or lung disease.
4.) Fear of mercury should not stop you from getting vaccines. Mercury comes in a lot of different forms, and when it comes to elements form makes a BIG difference. Chlorine, for example, by itself in its gas form, is a deadly poison. Chlorine paired up with sodium, on the other hand, is common table salt. Big difference. Most of our experience with mercury has been in the form of methylmercury-- that's the form of mercury that causes scares when it accumulates in seafood. Methylmercury is unquestionably a neurotoxin, and we have a good bit of data on it, and have established thresholds for how much is too much. By contrast, the thimerosol used in vaccines is an ethylmercury. The data that we have suggests that ethylmercury is much less toxic than methylmercury-- however, there has not been enough data to establish separate thresholds, so everyone has erred on the safe side and has used the same guidelines established for the more dangerous methylmercury. The amounts of mercury in vaccines never exceeded these very conservative guidelines, and there has never been any evidence that the mercury in the vaccines caused any problems.
There was no question however of the problems caused by contaminated multi-dose vaccine vials. There were cases of people getting very sick indeed from Staph and other bacteria sneaking into the vaccine vials in between patients. That's why they started using thimerosol-- to keep the vaccine clean and safe. Nowadays the manufacturing process is better, there are more single-use vials, and there are alternative preservatives. This, combined with the increased number of vaccines bringing the total mercury exposure closer to the safety thresholds, prompted the removal of thimersol from almost all of the currently used vaccines. It is still used in some adult tetanus and most adult flu vaccine.
5.) Flu shots DO work. If we didn't have good science showing a decrease in illness, the insurance companies would not be paying for it! Unfortunately, there IS a great deal of educated guesswork in deciding which flu strains to vaccinate for each year, and some years the vaccine is not a good match for the strains that sweep through the country. It also takes several weeks for the vaccine to take effect, so you are still vulnerable for a while after you get the shot. It also ONLY protects you from the influenza virus, and does nothing against RSV or the hundreds of cold viruses out there.
However, flu is a SCARY virus. Every couple decades a really virulent strain comes through and slaughters people. The flu epidemic in 1918-1920 killed over 50 MILLION. Even though one particular year's vaccine may not always be a great match, there is reason to believe that getting yearly flu shots gives you a much better repertoire of anti-flu antibodies, giving you much better odds of having some defense against rogue strains in the future. Flu is also truly miserable even when it's not a life-threatening case. People generally have a solid week of high fevers, wracking coughs, and all-over aches. For kids, that's a solid week of missed school, and a solid week of missed work for the parent caring for them, nevermind the additional days when the siblings then catch it. I recommend flu vaccine for all of my patients, and have my family vaccinated as well.
--Eloiwyn
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Topic: Infants and RSV (Read 3270 times)
