Expert: How Pharmacists Can Champion RSV Prevention After the Pandemic

Derek Webb, PharmD, member of the Virginia Board of Pharmacy and pharmacy manager at Food City, continued his conversation with Pharmacy Times®, discussing how pharmacists are uniquely positioned to lead respiratory syncytial virus (RSV) prevention efforts by identifying high-risk patients and collaborating with other health care providers to promote vaccination. He emphasized the pharmacist’s role as a community educator and advocate, bridging recommendations from physicians to patients. Webb also explained how the COVID-19 pandemic disrupted typical RSV patterns worldwide and highlighted the need to consider unintended consequences of widespread non-pharmaceutical interventions in future respiratory virus planning.

Pharmacy Times: How can pharmacists work with other health care providers to ensure a coordinated approach to RSV prevention in older adults?

Derek Webb, PharmD: I think that we have to realize that pharmacists—and we hear this all the time—are uniquely positioned. We’re boots on the ground, we’re on the front line, and over the years, we’ve become the champions of health care advocacy and vaccine advocacy. We are the educators in the community, if you will.

We really have to embrace that role and use our actual positioning in the health care industry to consider who’s high risk and who qualifies for this vaccine and that vaccine—and RSV is no different. It’s very easy in the workflow, in the community pharmacy setting, while you’re filling prescriptions, to take a close look at the medication profile or perhaps just ask the person when they come in, “Hey, I see you’re on this drug that’s used for X, Y, and Z condition. You may be eligible for an RSV vaccine.”

We have to be champions of that role. There’s no other health care provider that has the type of footprint that we have in the community setting. It’s also really important for health care providers to work together to have a seamless vision of health care. Pharmacists can absolutely advocate at the ground level for what physicians and health care providers are recommending.

So, if a person comes in and says, “Hey, my provider said that I really need to consider the RSV vaccine. Can you give me more information?”—that’s our opportunity to chime in and say, “Hey, this is an important thing for you to consider. And guess what? You do qualify for the vaccine.” We’re really there in an active role nowadays.

Pharmacy Times: How has the COVID-19 pandemic altered RSV outbreak patterns worldwide, and what lessons can we take into future respiratory virus planning?

Webb: At least in my lifetime, I’ve never seen anything quite like the COVID-19 pandemic. There’s no doubt now, looking back with a bird’s-eye view, that COVID-19 actually altered the pattern of different respiratory diseases. It altered the seasons.

To dive deeper into the issue for clarification—when COVID-19 really became a pandemic, we as health care providers advocated for non-pharmaceutical interventions (NPIs), which were face masks, social distancing, and closing down schools and other venues for a while. What that did was prevent people from exposing each other to different illnesses.

In the realm of respiratory illness, we created for a year or two this really naive portion of the population that just wasn’t exposed to any respiratory illness at all. Masks were very good to use, but at the same time, I don’t think we realized exactly what would result from that.

So after the pandemic ended, we lifted all these NPIs—no more masks, no more social distancing—and everybody started coughing on everybody again. Everybody started sharing diseases again. This naive group of the population that had no immunity to RSV suddenly experienced a massive outbreak—it blew up like a bomb. It spread all over the world, causing its own seasons within different continents.

It just wasn’t predictable anymore, because typically RSV season follows or parallels the flu season—from around September to January. Now, after the pandemic, it’s popping up everywhere at all times of the year. Truly, it altered the way respiratory illness presented itself worldwide.

As far as what we learn from that, I think it’s really important moving forward that we as health care providers consider the unintended consequences of using NPIs on a large scale. There’s nothing wrong with using masks, but we may want to really reserve those for situations like COVID—when we absolutely have no other option. What we don’t want to do is create unpredictable seasons of different respiratory illnesses, like we did with RSV.