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Updated: Jan 12, 2026
An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
The path to equitable respiratory syncytial virus prevention for infants: challenges and opportunities for global
Farina L Shaaban1, Rosalie W Groenendijk1, Ranju Baral2
1Department of Paediatric Immunology and Infectious Diseases, University Medical Centre Utrecht, Utrecht, Netherlands.
Insights
Gavi
Area of Science:
- Global Health
- Immunology
- Pediatrics
Background:
- Respiratory syncytial virus (RSV) significantly burdens infants globally, with 97% of mortality in low- and middle-income countries.
- High-income nations have introduced RSV prevention via maternal vaccination or monoclonal antibodies (mAbs) in infants, showing real-world effectiveness.
- Equitable access to RSV prevention remains a challenge, particularly in resource-limited settings.
Purpose of the Study:
- To review challenges and opportunities for expanding RSV prevention access for infants in resource-restricted settings.
- To align with WHO's Immunization Agenda 2030 and the UN's Leave No One Behind framework.
- To highlight urgent steps for global equitable access to RSV prevention.
Main Methods:
- Review of current RSV burden, vaccine and mAb development, and health economics.
- Analysis of policy, implementation, programmatic considerations, surveillance, and awareness.
- Synthesis of recent research advances and future directions.
Main Results:
- Maternal vaccination and infant mAbs demonstrate significant real-world effectiveness in reducing RSV-related illness and hospitalization.
- Despite global burden, RSV preventive strategies are largely absent in low- and middle-income countries.
- Gavi's approval of RSV maternal vaccination marks progress but requires further action for equitable access.
Conclusions:
- Expanding access to RSV prevention in resource-limited settings is critical.
- A multi-faceted approach addressing burden, development, economics, policy, and implementation is needed.
- Urgent, coordinated action is required to ensure all infants worldwide benefit from RSV prevention.
Abstract:
The approval for a respiratory syncytial virus (RSV) maternal vaccination programme by Gavi, The Vaccine Alliance, marks substantial progress toward equitable access, with important work still to come. Several countries, most of which are high-income, have introduced RSV immunisation either using a vaccine containing the RSV fusion protein in its prefusion conformation, which is given to pregnant people in late pregnancy, or by using a long-acting monoclonal antibody (mAb) administered directly to infants. Post-implementation real-world effectiveness data show a major impact in reducing medically attended RSV-lower respiratory tract illness and hospitalisation using either strategy. Although RSV poses a substantial burden to infants and vulnerable children worldwide, 97% of associated mortality occurs in low-income and middle-income countries. However, few of these countries have authorised and introduced RSV preventive strategies. This Review outlines the challenges and opportunities for expanding access to RSV prevention for infants in resource-restricted settings guided by WHO's Immunization Agenda 2030 and the UN's Leave No One Behind framework for non-discriminatory sustainable development. We discuss burden, vaccine and mAb development, health economics and impact modelling, policy, implementation and programmatic considerations, surveillance, and awareness as key RSV domains. This Review summarises recent advances in research and highlights the urgent steps needed to ensure equitable access to RSV prevention for all infants worldwide.
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