In early October, Spain launched an intensive RSV (respiratory syncytial virus) vaccination campaign for infants, with a view to making 2023 the first winter without bronchitis for infants. All people born between October 1, 2023 and March 31, 2024 will be vaccinated, and for adults, the government is already looking at how to fund the treatment.
Determined by the Ministry of Health as the second leading cause of death among minors in the world, the disease is an insidious and unpleasant disease that affects two of the most vulnerable groups in society: children and the elderly people) and resulted in approximately 160,000 deaths. One year per person. In addition to neonatal prophylaxis, the world is also preparing to receive a wider range of drugs to prevent respiratory syncytial virus, which will reach a wider range of people. The arrival of these vaccines and medicines will bring new hope to children under 5 and adults over 60.
“After decades of work, now there is Three new products available for preventing RSV.” State. join in).
Nearly all children will be infected with RSV by age 2, but for many, their symptoms are no more severe than a common cold. For others, RSV can be fatal. The Centers for Disease Control and Prevention (CDC) estimates that 58,000 to 80,000 children under the age of 5 and 60,000 to 160,000 adults over the age of 65 are hospitalized due to the virus in the United States each year. Globally, the National Institute of Allergy and Infectious Diseases in the same country shows that RSV affects both groups (as well as people with weakened immune systems), affecting a total of about 64 million people.
“RSV can be a very nasty respiratory virus,” said Bill Hanage, associate director of the Center for Infectious Disease Dynamics at the Harvard T.H. Chan School of Public Health. “It can cause very serious illness, hospitalization and death.”
While these new treatments are helping, news of their shortage has caused widespread confusion and concern. Here’s what experts say about which new vaccine or drug might be right for you or a loved one.
RSV is an airborne respiratory virus that typically spreads during the winter months (November to March). The virus is spread through respiratory droplets that are transferred from a sick person to a healthy person, or by touching a surface where the droplets are present and then touching the eyes, nose, or mouth.
When RSV affects the upper respiratory tract (nose, throat, and mouth), RSV symptoms include cough, nasal congestion, or mild sore throat. “The real problems arise when RSV attacks the lower respiratory tract,” explains Trahern Jones, an emergency pediatrician who specializes in infectious diseases at Intermountain Children’s Hospital in Salt Lake City.
In this condition, RSV replicates within the large and small airways of the lungs, especially the bronchioles. When these tubes become inflamed and swollen, a person’s airways can become clogged with mucus. “Many of us doctors have seen this hundreds of times: a little baby whose belly and chest are pumping up and down, nostrils flaring, struggling with every breath of air,” Jones explained.
Doctors often feel helpless when treating these young patients, he said, because there are no conventionally effective treatments for RSV. Antibiotics and antimicrobial drugs cannot kill the virus, so all doctors can do is provide supportive care, such as oxygen and fluids, until the infected person’s immune system clears the virus.
That’s why preventive drugs for RSV are so eagerly awaited.
Of the three new preventive products targeting RSV, two are vaccines. Both are suitable for adults 60 and older and people with chronic heart or lung disease or who are immunocompromised.
Both vaccines have a strong safety profile and have been shown to provide protection against RSV for at least two winter months. In clinical trials, Arexvy was 83% effective and Abrysvo was 89% effective.
“For a respiratory virus vaccine, these vaccines work really well, even better than the annual flu shot, and I would never be without a flu shot,” Jones said.
Abrysvo is a unique vaccine, however, because three months after it was approved in the U.S. for older adults, it was also approved for use in pregnant women in their third trimester, delivering protection in the form of antibodies to the fetus. VRS. In Europe, “arexvy is not recommended for use during pregnancy,” according to technical information published on the Spanish Medicines and Health Products Agency website.
In clinical trials, Abrysvo was 82% effective in preventing severe RSV infection in infants within 90 days of birth and 69% effective in preventing severe RSV infection within 180 days.
“This form of protection is called passive immunity because the baby relies on antibodies produced by the mother before birth, rather than on its own immune cells,” explains Shweta, an infectious disease physician and associate professor of medicine at the School of Medicine. Mayo Clinic (USA) Science, using name.
In addition to the protection provided by maternal antibodies, babies can be protected from RSV infection by injections of a non-vaccine drug called Beyfortus.
It is produced by AstraZeneca and Sanofi, and the FDA approved it in July 2023, while in Europe, where it is also known as nirsevimab, it was approved in October 2022. cells and cause infection,” explains Jason Nagata, a pediatrician at UCSF Benioff Children’s Hospital in San Francisco. The drug has been shown to reduce the risk of RSV-related hospitalizations and well visits in infants by 80 percent.
The CDC recommends that all infants younger than 8 months of age who are born during or entering the first season of RSV infection take a dose of Beyfortus. For a small group of children aged 8 to 19 months, a second dose is recommended during the second RSV season.
Shortly after it was approved, however, Beyfortus began experiencing shortages in the United States. Its manufacturer issued a statement saying “unprecedented demand” had depleted much of the drug’s supply.
In addition to shortages, Nagata said there are “financial barriers” to getting vaccinated for many families. While most health insurance plans are required to cover the cost of preventive drugs like Beyfortus, a loophole in the Affordable Care Act allows insurers to add new products to policies for a year, and some companies have been dragging their feet.
“Beyfortus could have developed a distribution plan to ensure fair access and ensure the most at-risk children were protected,” Hammett said. “That did not happen initially, hence the disparity in the availability of infant RSV vaccine across the country. It’s huge.”
Elizabeth Mack, a pediatric critical care physician at MUSC Children’s Health Center in Charleston, said the CDC is aware of these issues and has updated its guidance accordingly, “focusing on infants 6 months and younger and infants with underlying health conditions.”
While Shweta said “it’s unclear when this supply shortage will end,” vulnerable households and others should take precautions to limit the spread of RSV infection. These include washing hands frequently, covering coughs and sneezes, staying home when sick, and disinfecting high-touch surfaces frequently.
Since RSV is just one of the serious respiratory viruses circulating this time of year, staying up to date on your annual vaccinations can also help boost your immunity. “The secret to success is vaccinating everyone over 6 months of age and everyone who is eligible for RSV vaccination against influenza and COVID-19,” Mack said.