Respiratory syncytial virus vaccination and immunoprophylaxis: realising the potential for protection of young children
- PMID: 39265588
- DOI: 10.1016/S0140-6736(24)01699-4
Respiratory syncytial virus vaccination and immunoprophylaxis: realising the potential for protection of young children
Abstract
The search for safe and efficacious products to prevent severe respiratory syncytial virus (RSV) disease in young infants has lasted more than 60 years. In high-income and middle-income countries, two new products have been authorised: an RSV monoclonal antibody for administration to infants (nirsevimab) and an RSV prefusion F maternal vaccine (RSVpreF [Pfizer, Puurs, Belgium]) for administration to pregnant people. These products are not yet available in low-income and lower-middle-income countries, where most RSV deaths occur. Other papers in this Series describe the acute burden of RSV disease in young children, the effects of RSV infection in early childhood on long-term lung health, and the burden of RSV disease and disease prevention products in older adults. In this Series paper, we briefly review the efficacy, effectiveness, and safety of nirsevimab and RSVpreF maternal vaccine for protection of infants. We then explore potential regulatory, policy, and implementation pathways and provide case studies of intervention uptake in Spain and Argentina, and considerations for use in Kenya. We also explore the health economic evidence to inform product introduction decisions. With sufficient political will and affordable pricing, RSV disease prevention in infants can become a global reality.
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Conflict of interest statement
Declaration of interests CP reports funding to his institution from the Bill & Melinda Gates Foundation. He also has received travel support for RSV-related activities from WHO. PS is an employee of the Gates Foundation, an organisation that supports RSV activities at multiple organisations. RB reports funding to her institution and travel support for RSV-related activities from the Gates Foundation. CV is a member of the International Vaccine Institute's Global Advisory Group of Experts. JAF reports funding to her institution from the Gates Foundation, WHO, the Pfizer Foundation, and Merck. She also has received travel support for maternal immunisation related activities from the Gates Foundation. She was also a board member for the Salmonberry School and reports passive investments in exchange-traded funds that may include stocks in companies with interests in RSV products. FM-T reports honoraria paid to his institution from GSK, Pfizer, and Sanofi-AstraZeneca; consulting or advisory fees from GSK, Pfizer, Sanofi Pasteur, Janssen Pharmaceuticals, MSD, Seqirus, Biofabri, and AstraZeneca; and support for meeting attendance and travel from Pfizer, MSD, GSK, and Sanofi. He is also a member of the European Technical Advisory Group of Experts on Immunization, coordinator of the Spanish Pediatric Critical Trials Network, and coordinator of WHO collaborating Center for Vaccine Safety of Santiago de Compostela. He is principal investigator in randomised controlled trials of Ablynx, Abbot, Seqirus, Sanofi Pasteur MSD, Sanofi Pasteur, Cubist, Wyeth, Merck, Pfizer, Roche, Regeneron, Jansen, Medimmune, Novavax, Novartis, and GSK, with honoraria paid to his institution. RAK reports funding to her institution from the Gates Foundation, Sanofi, and National Institutes of Health. She is Chair of the WHO Product Development for Vaccines Advisory Committee. She has received travel support for RSV-related activities from WHO. All other authors declare no competing interests.
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