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Potential Effects on Elderly People From Nirsevimab Use in Infants
Iván Sanz-Muñoz1,2,3, Javier Castrodeza-Sanz1,4,5, José M Eiros1,6,7,8
1National Influenza Centre, Valladolid, Spain.
Insights
Nirsevimab offers potential protection against respiratory syncytial virus (RSV) for infants. However, its indirect benefit to the elderly is limited, making direct immunization a priority for older adults.
Area of Science:
- Immunology
- Virology
- Public Health
Background:
- Respiratory syncytial virus (RSV) poses a significant threat to vulnerable populations, including infants and the elderly.
- Nirsevimab, a monoclonal antibody, has shown promise in infant RSV prophylaxis.
- The potential for indirect protection of the elderly through infant Nirsevimab administration warrants investigation.
Purpose of the Study:
- To evaluate the potential indirect protective benefits of infant Nirsevimab therapy on the elderly population against RSV.
- To assess the limitations and significance of this indirect protection in the context of overall RSV transmission dynamics.
Main Methods:
- Review of existing studies on Nirsevimab's efficacy in reducing viral load in infants.
- Analysis of RSV transmission patterns in the elderly, considering common sources of infection.
- Consideration of RSV persistence in human reservoirs and year-round transmission.
Main Results:
- Nirsevimab's long half-life can reduce viral load in infants, potentially limiting RSV spread.
- RSV transmission among the elderly primarily occurs between peers or from school-aged children, not solely from infants.
- Year-round RSV circulation and human reservoirs diminish the sustained protective effect of infant-targeted Nirsevimab for the elderly.
Conclusions:
- While infant Nirsevimab may offer some limited, indirect protection to the elderly, it is not a primary strategy.
- The protective benefits for the elderly are likely to be testimonial rather than substantial.
- Prioritizing the immunization of the elderly with licensed and developing RSV vaccines is crucial for effective disease prevention.
Abstract:
Nirsevimab therapy has the potential to revolutionize infant respiratory syncytial virus (RSV) prophylaxis. But other populations suffering RSV, such the elderly or those over 60, may also be protected by using this novel antibody in the infant group. It is true that some studies link the use of nirsevimab to a reduction in the virus's ability to spread by lowering the viral load in infants as a result of the drug's long half-life. However, this protective effect may not be very significant because RSV transmission in the elderly typically comes from other elderly people or from school-aged children. Furthermore, RSV may be transmitted at any time of the year and not just during the period of nirsevimab protection due to its existence in human reservoirs. The reasons made here show that, even though nirsevimab treatment in infants may protect the elderly, this benefit would be limited and testimonial. Therefore, immunizing the elderly with currently licensed and developing vaccines should be a priority.
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