New advances in RSV: Is prevention attainable?

Area of Science:

• Pediatrics
• Infectious Diseases
• Vaccinology

Background:

• Respiratory syncytial virus (RSV) is a leading cause of infant hospitalization and mortality globally, particularly in low-middle income countries (LMICs).
• Severe RSV lower respiratory tract infection (LRTI) disproportionately affects young infants and those with underlying health conditions, leading to long-term respiratory issues.
• RSV-LRTI poses a significant global child health burden, necessitating effective preventive strategies.

Purpose of the Study:

• To review the efficacy and effectiveness of new interventions for preventing RSV-LRTI in infants and young children.
• To highlight the importance of equitable access to RSV prevention, especially in LMICs.

Main Methods:

• Review of Phase 2 and 3 clinical trial data for a maternal RSV pre-fusion (F) vaccine and the long-acting monoclonal antibody nirsevimab.
• Analysis of real-world effectiveness data from countries where these interventions have been implemented.
• Assessment of safety profiles and adverse events associated with the maternal RSV vaccine.

Main Results:

• The maternal RSV preF vaccine demonstrated high efficacy in preventing medically attended and severe RSV-LRTI in infants up to 6 months.
• Nirsevimab showed high efficacy in preventing RSV-LRTI hospitalization in both preterm and term infants, and in at-risk children.
• Both interventions were found to be safe, with high real-world effectiveness reported in implemented settings.

Conclusions:

• RSV-LRTI is now a preventable disease in infants and young children through maternal vaccination and monoclonal antibody administration.
• Rapid implementation in high-income countries contrasts with limited access in LMICs, highlighting a critical global health equity gap.
• Urgent expansion of access to these RSV preventive interventions is needed for all children worldwide to reduce disease burden and promote equity.