Opportunities and challenges facing RSV vaccination deployment

Wanda Filer, MD, MBA, FAAFP: RSV [respiratory syncytial virus] It is highly contagious.some things [can be done to prevent the spread of illness]. Wash your hands with soap and warm water for at least 20 seconds at a time. If you have symptoms such as coughing or sneezing, stay home from work and keep away from susceptible people around you. Also cover when you sneeze or cough. But most importantly, we hope that a vaccine will be developed soon. That would be your first line of defense. That is, get vaccinated.

One important thing to know about RSV is that even if a patient is recovering, they can shed the virus for up to 4 weeks if their immune system is compromised. In public, you may not even realize you’re being exposed to her RSV.

There is an RSV vaccine. One has been approved and perhaps another may be approved soon. We also have maternal respiratory syncytial virus vaccine. That goal is in progress. Not approved yet, but very close to approval. Vaccination of pregnant mothers is expected to pass passive immunity to the newborn, protecting not only the mother but also the baby during its most vulnerable period. Other forms of her RSV vaccine are also in development. If it continues in clinical trials, it probably won’t be available until 2024 or 2025.

The opportunities for RSV vaccines are immense. This is a very common infection in young children and adults. Morbidity and mortality are very high. I need to get vaccinated. It is expected that vaccination will probably be recommended once a year. At the time of this recording, these guidelines have not been formally formulated. In the next few weeks we will know exactly what we recommend and how long it will last. Pediatric vaccines are actually monoclonal antibodies that last for months. It can protect the child, provide immediate immunity, and lower the chances of serious infections and hospitalization. Adult vaccines are the more traditional vaccines and the first in more than 60 years since these vaccines were developed. Now is a very interesting time to start preventing this virus and saving lives.

There are various strategies to protect young children. One is maternal vaccination. Therefore, immunization is given to the mother and passive immunity is given. That passive immunity is passed on to newborns at birth and protects them during their most vulnerable first months. Then there is the infant vaccination, in which monoclonal antibodies are administered directly to the baby. The goal is to protect the child during that vulnerable period for several months. The infant strategy considers the month in which this dose is given. We have several months covered and we are waiting for the final recommendations. It will be interesting to see. I don’t think anyone is quite clear on how these two will get married, or which one. have to wait for ACIP [Advisory Committee on Immunization Practices] for making decisions.

There may be challenges in introducing an RSV vaccine. First, there is increasing vaccine fatigue among patients and clinicians. What I hear from medical sites is that many medical sites are understaffed. Pharmacies have been hit hard during the pandemic. Nevertheless, we have an opportunity to save lives with this vaccine. Another will be seen in the fall. Since this is the season for respiratory viruses, individuals will also be getting flu vaccines, and perhaps the latest COVID-19 vaccines will be available this fall. Then add the RSV vaccine. I don’t know if they can be used together in the adult world. That information isn’t clear, so I’d need some guidance on that. A human has only two arms, his. You don’t want to drop the drawer for the third shot. I need to wait and see. How do you prioritize this? How do you set these timings? Should they be a few weeks apart?

In fact, it poses difficulties for the patient. A challenge arises for clinical staff in terms of taking individuals to the hospital. [for a vaccine] In a timely manner. On the pediatric side, there is also the notion that the first vaccination in a particular month takes place in the neonatal unit. There are many medical directors in my role. In the last few weeks I have interviewed about 20 of them, 5 of them pediatricians. Every pediatrician wondered what his hospital would give it in the neonatal unit. They felt that this would require some change in clinical practice. These babies should be seen on the first or second day after birth.

A lot of it depends on payments and refunds. When the cost of that neonatal vaccine is lumped into regular newborn care, hospitals may not be able to afford it. If it were a carve-out strategy, hospitals would probably be willing to implement it. But we need to make sure all these children are vaccinated. The timing will be required. Another thing to add about the adult world is that in the adult world the patient does not know about her RSV. Children’s is well known, but the adult field requires a lot of education by the general public and clinicians. We are finally able to do something against RSV. That’s good news, but it will take many individuals to get the message across.

I edited the transcript for clarity.