Rise in RSV infections not due to ‘immune debt’, but failure to protect public health

Blaming the rise in pediatric respiratory viruses on stay-at-home orders is an erroneous guess, not based on science

The increase in pediatric respiratory syncytial virus (RSV) infections and associated hospitalizations is not due to an “immunity debt” created by masking and stay-at-home orders issued during the Covid-19 pandemic . The so-called immunity debt is a mistaken guess that is not based on science.

“RSV and other respiratory viruses are significantly more severe this year due to a complete abandonment of public health measures that have helped protect the public from Covid-19 and other respiratory illnesses,” said Deborah Burger. , RN and President of National Nurses United (NNU). “The lack of public health protections and the impact of Covid infections, reinfections and long Covid likely contribute to the significant impact of RSV on young children and infants. Promoting the idea of ​​“immunity debt” is not only unscientific, it is also harmful to public health. »

Articles stating that children have not been exposed to RSV since the start of the Covid-19 pandemic due to stay-at-home orders are inaccurate. Many children have already been exposed and infected with RSV in 2021. In fact, the RSV positivity rate were higher in 2021 than they are now in the United States. Additionally, RSV infections provide only partial immunity and individuals remain susceptible to repeated infections throughout their lives.

Unfortunately, the CDC seems to be promoting this idea of ​​“immune debt” as the reason for the current spike in respiratory viruses and hospitalizations, especially among children. During the CDC’s Nov. 4 media advisory, the agency explicitly stated that due to a lack of immunity, “these kids, if you will, need to be infected to move forward because it’s a disease [RSV] very common in children. However, asserting that children must be infected to clear their “immunity debt” offers little benefit to children, ignores individual risks of serious infections (especially in immunocompromised children), and ignores science. on the virus.

“There is no evidence that the increase in pediatric RSV is due to so-called immune debt,” Burger said. “Our immune system works constantly to protect us from infection and disease, even in the absence of exposure to pathogens. But some infections, like Covid, can disrupt the immune system, even with an initially mild or asymptomatic case. We know that children and adolescents can also develop long Covid.”

For example, a study published in Natural immunology in January 2022, found that immunological dysfunction can persist for more than eight months following mild to moderate Covid infection. In April 2022, the American Academy of Pediatrics noted that at least 75% of children and adolescents have had at least one Covid infectionalmost a third of which occurred during the Omicron surge last winter.

“To protect public health, we need a multi-layered approach to infection control,” Burger said. “Since the start of the pandemic, National Nurses United has advocated for multiple levels of infection control, including masking, social distancing, vaccination, testing, contract seeking, staying home when sick, and time off. sickness paid for workers.”

“We know we’re not safe until everyone is safe,” Burger continued. “We continue to fight for the strongest protections for health care and other frontline workers. We need the Occupational Safety and Health Administration to issue a permanent Covid standard to protect nurses and other healthcare workers.

National Nurses United is the largest and fastest growing union and professional association for registered nurses in the United States, with nearly 225,000 members nationwide.