As we approach the impending RSV season, marked by heightened transmission rates during winter, the advent of two groundbreaking products holds promise for protecting infants from severe respiratory syncytial virus (RSV) infections. A vaccine designed for pregnant individuals and an antibody treatment for infants have garnered approval, yet the sluggish rollout raises concerns about their availability. In an exclusive Q&A, Dr. Ruth Karron, a professor in International Health and director of the Johns Hopkins Center for Immunization Research, sheds light on these novel developments and their potential impact on curbing RSV infections in children.
Understanding RSV: A Persistent Threat
RSV, or respiratory syncytial virus, poses a considerable threat to infants and young children, often resulting in cold-like symptoms. However, severe cases lead to hospitalizations, with an estimated 58,000-80,000 children under the age of 5 affected annually in the U.S. Dr. Karron emphasizes that RSV is the leading cause of hospitalization for children under one year old in the country, affecting even those without apparent risk factors.
Risk Factors for Severe RSV Disease
Certain factors increase the likelihood of severe RSV disease, including premature birth, heart disease, and neurologic issues affecting swallowing and lung function. Surprisingly, a significant proportion of hospitalized children with RSV have no identified risk factors, emphasizing the virus’s unpredictability.
Historical Measures and Limitations
Historically, the primary preventive measure against RSV was palivizumab, or Synagis, an antibody requiring monthly administration during the RSV season. However, its high cost limited accessibility, prompting recommendations for selective use. Dr. Karron underscores the limitations of existing preventive measures, setting the stage for the introduction of new products in 2023.
The Dawn of “the Year of RSV”: Novel Protective Products
This year, marked as “the year of RSV,” introduces two highly effective products – nirsevimab (Beyfortus) and RSVpreF (Abrysvo). Beyfortus, an antibody developed by AstraZeneca and marketed by Sanofi, stands out for its prolonged efficacy with a single dose providing protection throughout the RSV season. Abrysvo, also an antibody treatment, functions as a vaccine for pregnant individuals, passing on antibodies to the baby.
Implementing New Protective Measures: Challenges and Enthusiasm
While the potential of these new products to reduce RSV burden is widely acknowledged, challenges persist in their implementation. Dr. Karron highlights issues related to the cost of Beyfortus and insurance coverage, particularly for small pediatric practices. The urgency to resolve these challenges is underscored by the onset of the RSV season, leaving some parents struggling to access these critical preventive measures.
Access for All: Addressing Disparities
Dr. Karron addresses concerns about equitable access, noting that Beyfortus is covered under Vaccines For Children (VFC), ensuring accessibility for Medicaid recipients. Efforts to increase VFC eligibility for hospitals aim to facilitate streamlined access for infants born during the RSV season.
Looking Ahead: Unraveling the Impact
As we navigate the unfolding RSV season, questions linger about the accessibility and impact of these innovative products. Dr. Karron expresses optimism that, despite current challenges, the collective goodwill and political commitment will ultimately pave the way for widespread access to these vital preventive measures.
Joshua Sharfstein, MD, Vice Dean for Public Health Practice and Community Engagement at the Johns Hopkins Bloomberg School of Public Health, and host of the Public Health On Call podcast, conducted the Q&A.
