June 5, 2023

Who is most at risk of serious complications from RSV?

RSV Vaccines and Monoclonal Antibodies in Development New tools in the prevention and treatment of respiratory syncytial virus (RSV) are moving through the development pipeline, undergoing regulatory review, and under discussion at the Advisory Committee on Immunization Practices (ACIP). As these tools are licensed and ultimately recommended, new options will be available to help reduce the burden of this serious, yet often underappreciated public health threat.

Recently, the National Foundation for Infectious Diseases (NFID) hosted an expert panel discussion to review the latest advancements in RSV prevention and treatment. Read on for key insights and important considerations for the future.

3 Things You Need to Know about RSV:

1. RSV Impacts People of All Ages

Each year in the US, RSV impacts all age groups, with infants, young children, and older adults at greater risk for severe illness and complications from RSV. Although most children will have an RSV infection before their 2nd birthday, infections can occur and reoccur at any age.

Sue Peschin, MHS, President and CEO, Alliance for Aging Research:

We must shift thinking on RSV, so people understand that it is not only a little kid's disease. Caregivers must also understand their role in making sure that they don't spread RSV to the little people in their lives. And then, we have a barrier around vaccine fatigue and talking about the various respiratory vaccines together.

2. Advancements in RSV Prevention Are Progressing Rapidly

New tools in development to prevent RSV include vaccines and monoclonal antibodies targeting specific populations, including infants, young children, older adults, pregnant women, and individuals with compromised immune systems. Following approval by the Food and Drug Administration (FDA) and recommendation by the Centers for Disease Control and Prevention (CDC), these tools will be critical for improving disease prevention in future respiratory seasons.

NFID Medical Director William Schaffner, MD:

RSV remains a major public health threat to individuals of all ages and requires a timely and coordinated public health response to help reduce the burden in the US. This is an exciting time in vaccinology, as decades of scientific research are now paying off in the form of breakthrough innovations in disease prevention and treatment. We must work together to prepare for implementation of new interventions.

Laura Riley, MD, Chair, Obstetrics and Gynecology, Weill Cornell:

We have learned a lot in the last several years. Most recently, we have seen that the COVID-19 vaccine protects pregnant mothers from severe infection, but we also know that those protective antibodies cross the placenta and can protect the baby in the first few months of life. I think the exciting thing on the horizon would be a maternal vaccine that would protect the baby in the first few months of life against RSV.

Yvonne (Bonnie) Maldonado, MD, Professor of Pediatrics (Infectious Diseases) and Health Research and Policy, Stanford University School of Medicine:

There are a number of RSV vaccine candidates coming down the pike for children, pregnant women, and adults, that we hope will see the light of day very soon. There also are monoclonal antibodies that exist now for prevention in the highest-risk populations, primarily in premature infants under 29 weeks of age.

3. There Is an Ongoing Need for Education among Patients, Caregivers, and Healthcare Professionals

In preparing for future implementation of these new tools, we must continue to build awareness of RSV as a public health threat and an appreciation of the benefits of prevention. While disease activity may vary from year to year, RSV can cause serious complications similar to other seasonal respiratory diseases including influenza (flu) and COVID-19.

RSV is not going to be one of those diseases that's going to go away. It will be with us for some time to come. And all children have a high likelihood of getting infected. Even if they are not hospitalized, they could develop bronchiolitis, which can lead to long-term impacts–including asthma.

“I think an issue with a maternal RSV vaccine will be people just not recognizing how serious it is for their newborns. I think if they understood the power in preventing that disease altogether, many more women will be willing to put their arms out and get the vaccine because there currently isn't another practical way of protecting children in those first six months of life.”

Older adults with declining immune systems and higher rates of chronic conditions should be concerned about RSV, and we need to ramp up our messaging, not only to protect the older adult population, but also for the impact that it will have on younger people.

Remaining challenges that need to be addressed include:

  • The need for broad, age-based recommendations to maximize the uptake of vaccines, treatments, or other tools in development
  • Implementation and payment issues to best support the introduction and rollout of prevention and treatment tools under review, as well as equitable access and ongoing use

New and innovative tools to prevent and treat RSV have the potential to significantly reduce the burden of disease in young children and older adults in the US. Successful implementation of these tools will rely on raising awareness about RSV and the burden of disease, and on appreciation of the benefits of prevention. There is a need for ongoing RSV research, education and disease awareness, as well as continued actions to improve equity and access.

NFID is committed to the ongoing work of raising awareness, convening experts to understand important challenges, and providing resources to help clinicians, patients, and caregivers.

Additional RSV Resources

To join the conversation and get the latest news on infectious diseases, follow NFID on Twitter using the hashtag #PreventRSV, like NFID on Facebook, follow NFID on Instagram, visit NFID on LinkedIn, listen and subscribe to the Infectious IDeas podcast, and subscribe to receive future NFID Updates.