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Published on: April 4, 2019
Outpatient respiratory syncytial virus infections and novel preventive interventions
Sarah F Hak1, Roderick P Venekamp2, Joanne G Wildenbeest1
1Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital/University Medical Center Utrecht.
Insights
New respiratory syncytial virus (RSV) preventions, including a maternal vaccine and monoclonal antibody, are available. These interventions offer significant protection for infants, impacting clinical practice and parental counseling.
Area of Science:
- Pediatrics
- Immunology
- Public Health
Background:
- Respiratory syncytial virus (RSV) imposes a substantial burden on young children, families, healthcare systems, and society.
- RSV accounts for significant doctor visits and hospitalizations in infants, and drives outpatient visits for older children.
- Existing morbidity from RSV includes wheezing and acute otitis media.
Approach:
- This review synthesizes current information on novel RSV prevention strategies.
- It addresses key questions for healthcare professionals to effectively counsel parents.
- The review assesses the potential impact of RSV prevention on clinical practice.
Key Points:
- A novel maternal RSV vaccine demonstrated 70.9% efficacy against severe RSV infection in the first 150 days post-birth.
- The long-acting monoclonal antibody, nirsevimab, reduced medically attended RSV infections by 79.5% within 150 days of administration.
- Both the maternal vaccine and nirsevimab have received regulatory approval in the USA and Europe.
Conclusions:
- Novel RSV immunizations are poised to significantly decrease the burden of RSV in infants.
- Effective implementation hinges on tailored parental guidance and education.
- While pediatric vaccines are pending, RSV will continue to present an outpatient challenge beyond infancy.
Purpose Of Review:
With interventions to prevent respiratory syncytial virus (RSV) infection within reach, this review aims to provide healthcare professionals with the latest information necessary to inform parents and assess the potential impact of RSV prevention on everyday practice. We address frequently asked questions for parental counseling.
Recent Findings:
Numerous studies emphasize the major burden of RSV on young children, parents, healthcare and society. In the first year of life, about 14% of healthy term infants visit a doctor and 2% require hospitalization due to RSV. In older children (1--5 years), RSV infections and associated morbidity (wheeze, acute otitis media) are major drivers of outpatient visits. A novel maternal RSV vaccine and long-acting mAb can provide protection during infants' first months of life. This maternal vaccine showed 70.9% efficacy against severe RSV infection within 150 days after birth; the mAb nirsevimab reduces medically attended RSV infections by 79.5% within 150 days after administration. Both gained regulatory approval in the USA (FDA) and Europe (EMA).
Summary:
Novel RSV immunizations hold promise to reduce the RSV burden in infants, with substantial impact on everyday practice. Tailored parental guidance will be instrumental for successful implementation. Awaiting pediatric vaccines, RSV infections beyond infancy will still pose a significant outpatient burden.
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