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Review
. 2024 Nov 25;12(12):1317.
doi: 10.3390/vaccines12121317.

Respiratory Syncytial Virus: A WAidid Consensus Document on New Preventive Options

Matteo Riccò  1 , Bahaa Abu-Raya  2   3   4 , Giancarlo Icardi  5   6 , Vana Spoulou  7 , David Greenberg  8 , Oana Falup Pecurariu  9   10 , Ivan Fan-Ngai Hung  11 , Albert Osterhaus  12 , Vittorio Sambri  13   14 , Susanna Esposito  15
Affiliations
Review

Respiratory Syncytial Virus: A WAidid Consensus Document on New Preventive Options

Matteo Riccò et al. Vaccines (Basel). .

Erratum in

Abstract

Background/Objectives: Respiratory syncytial virus (RSV) is a leading cause of respiratory infections, particularly affecting young infants, older adults, and individuals with comorbidities. Methods: This document, developed as a consensus by an international group of experts affiliated with the World Association of Infectious Diseases and Immunological Disorders (WAidid), focuses on recent advancements in RSV prevention, highlighting the introduction of monoclonal antibodies (mAbs) and vaccines. Results: Historically, RSV treatment options were limited to supportive care and the monoclonal antibody palivizumab, which required multiple doses. Recent innovations have led to the development of long-acting mAbs, such as nirsevimab, which provide season-long protection with a single dose. Nirsevimab has shown high efficacy in preventing severe RSV-related lower respiratory tract infections (LRTIs) in infants, reducing hospitalizations and ICU admissions. Additionally, new vaccines, such as RSVpreF and RSVpreF3, target older adults and have demonstrated significant efficacy in preventing LRTIs in clinical trials. Maternal vaccination strategies also show promise in providing passive immunity to newborns, protecting them during the most vulnerable early months of life. This document further discusses the global burden of RSV, its economic impact, and the challenges of implementing these preventative strategies in different healthcare settings. Conclusions: The evidence supports the integration of both passive (mAbs) and active (vaccines) immunization approaches as effective tools to mitigate the public health impact of RSV. The combined use of these interventions could substantially reduce RSV-related morbidity and mortality across various age groups and populations, emphasizing the importance of widespread immunization efforts.

Keywords: RSV; RSV vaccine; lower respiratory tract infections; maternal immunization; monoclonal antibodies; nirsevimab.

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Conflict of interest statement

BA received an honorarium for participating in live meetings from Sanofi Pasteur France and Canada related to pertussis and RSV. BA received a nominal payment as a member of a data and safety monitoring board for a study conducted by Chulalongkorn University (Bangkok, Thailand). BA is a co-investigator on studies funded by GSK, Pfizer, Merck, Moderna, Vaccitech, and Inventprise. All funds were paid to his institute, and he did not receive any personal payments. SE received an honorarium for participating in live meetings from Sanofi Pasteur and Pfizer. SE is a co-investigator on a study funded by Merck. All funds were paid to her institute, and she did not receive any personal payments. The other authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure A1
Figure A1
Schematic comparison of the seasonal immunization granted by nirsevimab (5 months after the delivery, subfigure (a)) and by the maternal vaccination strategy (6 months after the birth, subfigure (b)).
Figure 1
Figure 1
Time trend of respiratory specimens collected since 2016 in EU countries and the corresponding prevalence rate of positive specimens. Original elaboration from data reported by the ECDC Atlas of Infectious Diseases (https://atlas.ecdc.europa.eu/public/index.aspx), accessed on 6 November 2024 [141].
Figure 2
Figure 2
Strategy for the delivery of nirsevimab as recommended by the German Standing Committee on Vaccinations (STIKO) [203].
Figure 3
Figure 3
Summary of Vaccine Efficacy with corresponding 95% Confidence Intervals (95%CI) in the prevention of lower respiratory tract illnesses (LRTI) with three or more findings (a) and with two clinical findings (b) during the first and second respiratory syncytial virus (RSV) season in adults ≥ 60 years [28,87,210,213,221,241,242,243].
Figure 4
Figure 4
Summary of the decline of Vaccine Efficacy (reported with their corresponding 95% Confidence Intervals [95%CI]) in the prevention of lower respiratory tract illnesses (LRTI) three or more findings during the first and second respiratory syncytial virus (RSV) season [28,87,210,213,221,241,242,243,257]. Preliminary data on season 3 of RSVpreF3 was retrieved from the ACIP Meeting of 24 October 2024 [258].
Figure 5
Figure 5
Summary of current recommendations for the delivery of RSV preventive measures in adults and children, as provided by the United States CDC and ACIP [237,304,305,306].
See this image and copyright information in PMC

References

    1. Feng Z., Xu L., Xie Z. Receptors for Respiratory Syncytial Virus Infection and Host Factors Regulating the Life Cycle of Respiratory Syncytial Virus. Front. Cell Infect. Microbiol. 2022;12:858629. doi: 10.3389/fcimb.2022.858629. - DOI - PMC - PubMed
    1. Collins P.L., Fearns R., Graham B.S. Respiratory Syncytial Virus: Virology, Reverse Genetics, and Pathogenesis of Disease. Curr. Top. Microbiol. Immunol. 2013;372:3–38. doi: 10.1007/978-3-642-38919-1_1. - DOI - PMC - PubMed
    1. Miller R.J., Mousa J.J. Structural Basis for Respiratory Syncytial Virus and Human Metapneumovirus Neutralization. Curr. Opin. Virol. 2023;61:101337. doi: 10.1016/j.coviro.2023.101337. - DOI - PMC - PubMed
    1. Shi T., Denouel A., Tietjen A.K., Campbell I., Moran E., Li X., Campbell H., Demont C., Nyawanda B.O., Chu H.Y., et al. Global Disease Burden Estimates of Respiratory Syncytial Virus-Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta-Analysis. J. Infect. Dis. 2021;222:S577–S583. doi: 10.1093/infdis/jiz059. - DOI - PubMed
    1. Li Y., Wang X., Blau D.M., Caballero M.T., Feikin D.R., Gill C.J., Madhi S.A., Omer S.B., Simões E.A.F., Campbell H., et al. Global, Regional, and National Disease Burden Estimates of Acute Lower Respiratory Infections Due to Respiratory Syncytial Virus in Children Younger than 5 Years in 2019: A Systematic Analysis. Lancet. 2022;399:2047–2064. doi: 10.1016/S0140-6736(22)00478-0. - DOI - PMC - PubMed

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