Second RSV and Bronchiectasis

I saw my pulmonologist in Penn’s bronchiectasis clinic earlier this month. We reviewed vaccines and he didn’t mention another RSV.
I did a quick google search of lit and didn’t find a study recommending it (not saying it isn’t there), I did find the recommendation for current timing as of this summer.
From MMWR Aug 15
“Eligible adults are currently recommended to receive a single dose of RSV vaccine; adults who have already received RSV vaccination should not receive another dose. A single dose provides protection for at least two RSV seasons. The need for additional RSV vaccine doses will be evaluated by ACIP in the future; ACIP will update recommendations as needed.”

We are all human, maybe the pulmonologist was thinking, accidentally, of another vaccine. You might think of also confirming, via messaging the office, if he meant to say two or if you might have misunderstood. possibly?? Be interesting to see what answer you receive if you do follow up with the office to see if you get the same answer...two RSV.
Barbara

According to the Minnesota Department of Health there is not yet a recommendation for a second RSV dose for anyone except the severely immunocompromised.

I was told it was once and done by the Pharmacy. My arm swelled up and had several large red bumps after the shot, so I am not getting it again. That's interesting that your Dr. is telling you there is a second shot available and that Pharmacies don't know that.

Your arm, your decision. 🙂 Second shots are not approved for general distribution. The pharmacies are aware of the probability of annual RSV shots. But this has not been approved yet and the pharmacy should not be giving them to walk ins who request it. It is very likely it will be available soon but further testing is needed before the pharmacy can give out without a doctors script. I am surprised your pharmacy told you once and done. I don't think it was ever believed to be a one time life time shot.

I think @blm1007blm1007 and Sue have provided reasonable explanations for MD’s advice. The MD could have misspoken or the OP is severely immunocompromised (“no antibodies” was mentioned” and the MD may think an exception is appropriate. If I were patient, I’d ask why he thinks I’d be exception to guideline.
My pulmonologist makes thoughtful and deliberate decisions and welcomes discussion. If he told me, after I questioned it, that he thought I needed another, I’d follow his advice. If my young PMD (or first pulmonologist) suggested it, I’d be reluctant,

Absolutely. My pulmo discussed getting the second one because of some my lack of antibodies, the fact that I will have to get on a plane soon (I can't be around others). The plane is unavoidable and not for anything fun. My immunologist now agrees. They are also giving me pemgarda. I was just curious if anyone else had gotten it. Thanks for all your responses.

If it were I, I would follow the immunologist's recommendation. Anything related to vaccines, immune system, disease prevention etc I check I with and believe immunologist over the pulmonologist. You do need to make sure your immunologist is more of an immunologist rather than a general allergist/ immunologist. Allergists are board-certified in both allergy and immunology, and often more well-versed in allergy than immunology. Immune deficiencies are rare, and Allergists see more allergy patients than immunology patients.

Since you have CVID what type of Ig replacement are you getting? IVIg or Subq? Many people find subq is more protective as it keeps the difference between troughs and peaks more level than IVIg.