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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
An implementation framework for planning an RSV immunization program for infants using the long-acting monoclonal
Jody Tate1, Elena Bozzola2, Michelle Fiscus3
1The Health Policy Partnership, London, United Kingdom.
Insights
A new framework aids health systems in planning the delivery of long-acting monoclonal antibody (mAb) immunization programs to prevent severe respiratory syncytial virus (RSV) illness in infants. This approach ensures widespread access to vital RSV protection for vulnerable populations.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Health systems strengthening
Background:
- Respiratory syncytial virus (RSV) causes significant global childhood hospitalizations, particularly in infants under one year.
- While most infections are mild, RSV can lead to severe lower respiratory tract infections (LRTIs) like bronchiolitis and pneumonia.
- Two new immunizations, a maternal vaccine (RSVpreF) and a long-acting monoclonal antibody (mAb) (nirsevimab), aim to protect infants from severe RSV disease.
Purpose of the Study:
- To present a framework for evidence-based planning of long-acting mAb immunization programs for RSV prevention.
- To guide health systems in the preparation and implementation of widespread nirsevimab delivery.
- To offer a tool for improving ongoing implementation in countries where programs have already started.
Main Methods:
- Development of a framework based on a pragmatic literature review.
- Incorporation of authors' perspectives and early implementation experiences.
- Organization of the framework into five domains aligned with WHO health system building blocks.
Main Results:
- The framework addresses key implementation areas: governance, funding, demand, service delivery, and monitoring.
- It provides a structured approach to planning for the novel strategy of universal long-acting mAb use.
- Examples of considerations within each domain are provided to facilitate practical application.
Conclusions:
- Effective planning is crucial for the successful implementation of novel immunization strategies like long-acting mAbs for RSV.
- The proposed framework offers a comprehensive guide for health systems to prepare for and optimize RSV immunization programs.
- This structured approach supports the goal of protecting all infants from severe RSV-related illness.
Abstract:
Respiratory syncytial virus (RSV) infects most children by the age of two. Although the majority experience mild cold-like symptoms, RSV can lead to serious lower respiratory tract infections (LRTIs), including bronchiolitis and pneumonia; the virus is responsible for 3.6 million hospital admissions in children under five globally. More than 70% of RSV-related hospitalizations in children under 1 year of age occur in infants who are otherwise healthy and born at term. Two immunizations have recently been approved with the aim of protecting all infants from severe RSV-related illness: a maternal vaccine, RSVpreF, and a long-acting monoclonal antibody (mAb), nirsevimab. The universal use of a long-acting mAb is a novel approach to disease prevention. It therefore requires careful planning to prepare health systems for widespread delivery. We developed a framework to encourage evidence-based planning for the implementation of RSV immunization programs using the long-acting mAb; the framework can also be used to guide improvements in countries where implementation has already begun. The framework was developed based on a pragmatic review of the published literature as well as the authors' perspectives and early experiences of implementation. It is organized into five domains, based broadly on the World Health Organization's health system building blocks: governance and leadership, reimbursement and funding, demand, service provision, and monitoring and assessment. This article provides an overview of the five domains of the framework, and examples of elements that should be considered under each.
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