Recommendations on Respiratory Syncytial Virus (RSV) Immunization Strategies for Infants and Young Children in...

Area of Science:

• Pediatrics
• Immunology
• Public Health

Background:

• Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract infections in infants.
• RSV infection leads to significant childhood morbidity and mortality globally.
• Malaysia experiences year-round RSV activity, necessitating tailored prevention strategies.

Purpose of the Study:

• To develop evidence-based recommendations for RSV immunization in Malaysia.
• To address the need for infant and/or maternal vaccination against RSV.
• To provide guidance for the Malaysian pediatric community.

Main Methods:

• An expert panel was convened by the College of Pediatrics, Academy of Medicine of Malaysia.
• Real-world evidence on RSV immunization informed the panel's deliberations.
• Recommendations were developed considering the Malaysian context and year-round RSV circulation.

Main Results:

• The expert panel recommends targeted immunization with long-acting RSV monoclonal antibody (mAb) for high-risk infants.
• This approach is considered a pragmatic initial step.
• A subsequent scale-up to universal infant immunization is advised as resources allow.

Conclusions:

• Immunization is the most effective method to prevent RSV-related lower respiratory tract infections in children.
• Year-round maternal vaccination (28-36 weeks gestation) and infant immunization at six months are proposed.
• These strategies may overcome challenges posed by unclear RSV seasonality.