An RSV vaccine has been approved for people over 60. But what about young children?
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The Therapeutic Goods Administration (TGA) has approved a vaccine against respiratory syncytial virus (RSV) in Australia for the first time. The shot, called Arexvy and manufactured by GSK, will be available by prescription to adults over 60.
RSV is a contagious respiratory virus which causes an illness similar to influenza, most notably in babies and older adults.
So while it will be good to have an RSV vaccine available for older people, where is protection up to for the youngest children?
A bit about RSV
RSV was discovered in chimpanzees with respiratory illness in 1956, and was soon found to be a common cause of illness in humans.
There are two key groups of people we would like to protect from RSV: babies (up to about one year old) and people older than 60.
Babies tend to fill up hospitals during the RSV season in late spring and winter in large numbers, but severe infection requiring admission to intensive care is less common.
In babies and younger children, RSV generally causes a wheezing asthma-like illness (bronchiolitis), but can also cause pneumonia and croup.
Although there are far fewer hospital admissions among older people, they can develop severe disease and die from an infection.
Prostock-studio/Shutterstock
RSV vaccines for older people
For older adults, there are actually several RSV vaccines in the pipeline. The recent Australian TGA approval of Arexvy is likely to be the first of several, with other vaccines from Pfizer and Moderna currently in development.
The GSK and Pfizer RSV vaccines are similar. They both contain a small component of the virus, called the pre-fusion protein, that the immune system can recognise.
Both vaccines have been shown to reduce illness from RSV by more than 80% in the first season after vaccination.
In older adults, side effects following Arexvy appear to be similar to other vaccines, with a sore arm and generalised aches and fatigue frequently reported.
Unlike influenza vaccines which are given each year, it is anticipated the RSV vaccine would be a one-off dose, at least at this stage.
Protecting young children from RSV
Younger babies don’t tend to respond well to some vaccines due to their immature immune system. To prevent other diseases, this can be overcome by giving multiple vaccine doses over time. But the highest risk group for RSV are those in the first few months of life.
To protect this youngest age group from the virus, there are two potential strategies available instead of vaccinating the child directly.
The first is to give a vaccine to the mother and rely on the protective antibodies passing to the infant through the placenta. This is similar to how we protect babies by vaccinating pregnant women against influenza and pertussis (whooping cough).
The second is to give antibodies directly to the baby as an injection. With both these strategies, the protection provided is only temporary as antibodies wane over time, but this is sufficient to protect infants through their highest risk period.
Image Point Fr/Shutterstock
Abrysvo, the Pfizer RSV vaccine, has been trialled in pregnant women. In clinical trials, this vaccine has been shown to reduce illness in infants for up to six months. It has been approved in pregnant women in the United States, but is not yet approved in Australia.
An antibody product called palivizumab has been available for many years, but is only partially effective and extremely expensive, so has only been given to a small number of children at very high risk.
A newer antibody product, nirsevimab, has been shown to be effective in reducing infections and hospitalisations in infants. It was approved by the TGA in November, but it isn’t yet clear how this would be accessed in Australia.
What now?
RSV, like influenza, is a major cause of respiratory illness, and the development of effective vaccines represents a major advance.
While the approval of the first vaccine for older people is an important step, many details are yet to be made available, including the cost and the timing of availability. GSK has indicated its vaccine should be available soon. While the vaccine will initially only be available on private prescription (with the costs paid by the consumer), GSK has applied for it to be made free under the National Immunisation Program.
In the near future, we expect to hear further news about the other vaccines and antibodies to protect those at higher risk from RSV disease, including young children.
Allen Cheng, Professor of Infectious Diseases, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How Not to Die – by Dr. Michael Greger
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Dr. Greger (of “Dr. Greger’s Daily Dozen” fame) outlines for us in cold hard facts and stats what’s most likely to be our cause of death. While this is not a cheery premise for a book, he then sets out to work back from there—what could have prevented those specific things?
Some of the advice is what you might expect: eat green things and whole grains, skip the bacon. Other advice is less well-known: get a daily dose of curcumin/turmeric, take it with black pepper. Works wonders. If you want to add in daily exercises, just lifting the book could be a start; weighing in at 678 pages, it’s an information-dense tome that’s more likely to be sifted through than read cover-to-cover.
If you’re a more cynical sort, you might note that since the book doesn’t confer immortality, but does help us avoid statistically likely causes of death, logically it significantly increases our chances of dying in a statistically unlikely way. (Ha! Your mental exercise for today will be decoding that sentence )
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The Art and Science of Connection – by Kasley Killam, MPH
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We can eat well, exercise well, and even sleep well, and we’ll still have a +53% increased all-cause mortality if we lack social connection—even if we technically have support and access to social resources, just not the real human connection itself. And as we get older, it gets increasingly easy to find ourselves isolated.
The author is a social scientist by profession, and it shows. None of what she shares in the book is wishy-washy; it has abundant scientific references coming thick and fast, and a great deal of clarity with regard to terms, something often not found in books of this genre that lean more towards the art than the science.
On which note, for the reader who may be thinking “I am indeed quite alone”, she also offers proven techniques for remedying that; not in the way that many books use the word “proven” to mean “we got some testimonials”, but rather, proven in the sense of “we did science to it and based on these 17 large population-based retrospective cohort studies, we can say with 99% confidence that this is an effective tool to mediate improved social bonds and social health outcomes”.
To this end, it’s a very practical book also, and should bestow upon any isolated reader a sense of confidence that in fact, things can be better. A particular strength is that it also looks at many different scenarios, so for the “what if I…” people with clear reasons why social connection is not abundantly available, yes, she has such cases covered too.
Bottom line: if you’d like to live more healthily for longer, social health is an underrated and oft-forgotten way of greatly increasing those things, by science.
Click here to check out The Art And Science Of Social Connection, and get connected!
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Prostate Health: What You Should Know
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Prostate Health: What You Should Know
We’re aware that very many of our readers are women, who do not have a prostate.
However, dear reader: if you do have one, and/or love someone who has one, this is a good thing to know about.
The prostate gland is a (hopefully) walnut-sized gland (it actually looks a bit like a walnut too), that usually sits just under the bladder.
See also: How to Locate Your Prostate*
*The scale is not great in these diagrams, but they’ll get the job done. Besides, everyone is different on the inside, anyway. Not in a “special unique snowflake” way, but in a “you’d be surprised how much people’s insides move around” way.
Fun fact: did you ever feel like your intestines are squirming? That’s because they are.
You can’t feel it most of the time due to the paucity of that kind of nervous sensation down there, but the peristaltic motion that they use to move food along them on the inside, also causes them push against the rest of your guts, on the outside of them. This is the exact same way that many snakes move about.
If someone has to perform an operation in that region, sometimes it will be necessary to hang the intestines on a special rack, to keep them in one place for the surgery.
What can go wrong?
There are two very common things that can go wrong with the prostate:
- Benign Prostate Hyperplasia (BPH), otherwise known as an enlarged prostate
- Prostate cancer
For most men, the prostate gland continues to grow with age, which is how the former comes about so frequently.
For everyone, due to the nature of the mathematics involved in cellular mutation and replication, we will eventually get cancer if something else doesn’t kill us first.
- Prostate cancer affects 12% of men overall, and 60% of men aged 60+, with that percentage climbing each year thereafter.
- Prostate cancer can look like BPH in the early stages (and/or, an enlarged prostate can turn cancerous) so it’s important to not shrug off the symptoms of BPH.
How can BPH be avoided/managed?
There are prescription medications that can help reduce the size of the prostate, including testosterone blockers (such as spironolactone and bicalutamide) and 5α-reductase inhibitors, such as finasteride. Each have their pros and cons:
- Testosterone-blockers are the heavy-hitters, and work very well… but have more potential adverse side effects (your body is used to running on testosterone, after all)
- 5α-reductase inhibitors aren’t as powerful, but they block the conversion of free testosterone to dihydrogen testosterone (DHT), and it’s primarily DHT that causes the problems. By blocking the conversion of T to DHT, you may actually end up with higher serum testosterone levels, but fewer ill-effects. Exact results will vary depending on your personal physiology, and what else you are taking, though.
There are also supplements that can help, including saw palmetto and pumpkin seed oil. Here’s a good paper that covers both:
We have recommended saw palmetto before for a variety of uses, including against BPH:
Too much or too little testosterone? This one supplement may fix that
You might want to avoid certain medications that can worsen BPH symptoms (but not actually the size of the prostate itself). They include:
- Antihistamines
- Decongestants
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Tricyclic antidepressants (most modern antidepressants aren’t this kind; ask your pharmacist/doctor if unsure)
You also might want to reduce/skip:
- Alcohol
- Caffeine
In all the above cases, it’s because of how they affect the bladder, not the prostate, but given their neighborliness, each thing affects the other.
What if it’s cancer? How do I know and what do I do?
The creator of the Prostate Specific Antigen (PSA) test has since decried it as “a profit-driven health disaster” that is “no better than a coin toss”, but it remains the first go-to of many medical services.
However, there’s a newer, much more accurate test, called the Prostate Screening Episwitch (PSE) test, which is 94% accurate, so you might consider asking your healthcare provider whether that’s an option:
The new prostate cancer blood test with 94 per cent accuracy
As for where to go from there, we’re out of space for today, but we previously reviewed a very good book about this, Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer, and we highly recommend it—it could easily be a literal lifesaver.
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Beat Cancer Kitchen – by Chris Wark & Micah Wark
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When we eat, many things can increase our cancer risk. Some we might remember to avoid, like ultra-processed foods and red meat. Others might be more neutral when it comes to cancer, neither good nor bad.
But! Some foods also have cancer-fighting properties. Which means reducing cancer risk, and/or having an anti-proliferative effect (i.e., shrinks or at least slows growth of tumors), in the event of already having cancer.
That’s what Chris & Micah Wark are offering here; a cookbook built around anti-cancer foods—after the former beat his own cancer with the help of the latter. He had surgery, but skipped chemo, preferring to look to nutrition to keep cancer-free. Now 18 years later, and so far, so good.
The dietary advice here is entirely consistent with what we’d offer at 10almonds; it’s plant-based, and high in anti-cancer phytonutrients.
The recipes themselves (of which there are about 70-ish) are as delicious and simple as the title suggests, and/but you might want to know:
- On the one hand, many recipes are things like sauces, condiments, or dressings, which in a recipe book can sometimes feel like underdelivering on the promise of recipes when we expect full meals
- On the other hand, those things if you just purchase them ready-made are usually the things with the most ultra-processed products, thus, having anticancer homemade versions instead here can actually make a very big difference
- On the third hand, there areplenty of starters/mains/desserts too!
Bottom line: if you’re looking for an anti-cancer cookbook, this is a very good one whose ingredients aren’t obscure (which can otherwise be a problem for some books of this kind)
Click here to check out Beat Cancer Kitchen, and take good care of yourself and your loved ones!
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Aging Well: Exercise, Diet, Relationships
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
I am interested in the following: Aging, Exercise, Diet, Relationships, Purpose, Lowering Stress
You’re going to love our Psychology Sunday editions of 10almonds!
You may particularly like some of these:
- Seriously Useful Communication Skills! ← this is about relationship stuff
- Lower Your Cortisol! (Here’s Why & How) ← about “the stress hormone”
- How To Set Your Anxiety Aside ← these methods work for stress too
(This coming Psychology Sunday will have a feature specifically on stress, so do make sure to read that when it comes out!)
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When Your Brain’s “Get-Up-And-Go” Has Got Up And Gone…
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Sometimes, there are days when the body feels heavy, the brain feels sluggish, and even the smallest tasks feel Herculean.
When these days stack up, this is usually a sign of depression, and needs attention. Unfortunately, when one is in such a state, taking action about it is almost impossible.
Almost, but not quite, as we wrote about previously:
The Mental Health First-Aid You’ll Hopefully Never Need ← this is about as close to true mental health bootstrapping as actually works
Today though, we’re going to assume it’s just an off-day or such. So, what to do about it?
Try turning it off and on again
Sometimes, a reboot is all that’s needed, and if napping is an option, it’s worth considering. However, if you don’t do it right, you can end up groggy and worse off than before, so do check out:
How To Be An Expert Nap-Artist (No More “Sleep Hangovers”!)
If your exhaustion is nevertheless accompanied by stresses that are keeping you from resting, then there’s another “turn it off and on again” process for that:
Fuel in the tank
Our brain is an energy-intensive organ, and cannot run on empty for long. Thus, lacking energy can sometimes simply be a matter of needing to supply some energy. Simple, no? Except, a lot of energy-giving foods can cause a paradoxical slump in energy, so here’s how to avoid that:
Eating For Energy (In Ways That Actually Work)
There are occasions when exhausted, when preparing food seems like too much work. If you’re not in a position to have someone else do it for you, how can you get “most for least” in terms of nutrition for effort?
Many of the above-linked items can help (a bowl of nuts and/or dried fruit is probably not going to break the energy-bank, for instance), but beyond that, there are other considerations too:
How To Eat To Beat Chronic Fatigue (While Chronically Fatigued) ← as the title tells, this is about chronic fatigue, but the advice therein definitely goes for acute fatigue also.
The lights aren’t on
Sometimes it may be that your body is actually fine, but your brain is working in a clunky fashion at best. Assuming there is no more drastic underlying cause for this, a lack of motivation is often as simple as a lack of appropriate dopamine response. When that’s the case…
Lacking Motivation? Science Has The Answer
If, instead, the issue is more serotonin-based than dopamine based, then green places with blue skies are ideal. Depending on geography and season, those things may be in short supply, but the brain is easily tricked with artificial plants and artificial sunlight. Is it as good as a walk in the park on a pleasant summer morning? Probably not, but it’s many times better than nothing, so get those juices flowing:
Neurotransmitter Cheatsheet ← four for the price of one, here!
Schedule time for rest, or your body/brain will schedule it for you
There’s a saying in the field of engineering that “if you don’t schedule time for maintenance, your equipment will schedule it for you”, and the same is true of our body/brain. If you’re struggling to get good quantity, here’s how to at least get good quality:
How To Rest More Efficiently (Yes, Really)
And, importantly,
7 Kinds Of Rest When Sleep Is Not Enough
Take care!
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