If alarms were raised last year due to unusual rates of respiratory syncytial virus (RSV), especially bronchiolitis in infants and children, and certain spikes in COVID-19 and influenza (the so-called triple epidemic or “triple epidemic”), From English triple epidemic), the arrival this year of new vaccines against the first disease may change the course of the triad.
For this vaccination campaign, which starts at the end of the year…
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If alarms were raised last year due to unusual rates of respiratory syncytial virus (RSV), especially bronchiolitis in infants and children, and certain spikes in COVID-19 and influenza (the so-called triple epidemic or “triple epidemic”), From English triple epidemic), the arrival this year of new vaccines against the first disease may change the course of the triad.
For the vaccination campaign starting in late September, work has begun to expand the supply of the drug to use the monoclonal antibody nirsevimab for the first RSV immunization of infants. People aged 60 or older are also considered to be at risk of lower respiratory tract disease (LRTD) caused by this viral infection, and the European Medicines Agency (EMA) approved an adjunctive dose of Arexvy last June.
“Monoclonal antibodies as preventive therapy for RSV could avoid the last winter we experienced. It is a very important issue that we have to deal with this triple epidemic,” said Europe, associated with the European Federation of Pharmaceutical Industries and Associations (Efpia) Sibilia Quilici, executive director of the Vaccine Organization, reiterated. In fact, by 2025, the US regulator FDA may approve a combination formulation (for SARS-CoV-2 and influenza) in the US, with Moderna (also working on a triple formulation of RSV) announcing the start of its clinical trials. This potential solution is undergoing Phase 3 trials. Pfizer has another project underway that is in its initial stages.
However, larger treatment arms do not ensure greater population coverage. If 2021 was the best year yet, with about 69% of people getting a flu shot, last year that number dropped to 65%. Across Covid-19, the figures are slightly higher, with 77% of those over 80 and 67% of those aged 70 to 79 vaccinated. “It is important to know that this proportion was around 50% before the pandemic. Now, it remains to be seen whether these numbers will remain there and whether we manage to increase or decrease them slightly,” said the President of the Spanish Vaccinology Association (AEV) Jaime Jesús Pérez Martín says. Keep in mind it’s too early to know how the campaign will play out, but coverage targets published by Health identify the ideal figure for 2025 at 75%.
Now the acute respiratory infection (ARI) surveillance system Sivira, the latest indicator of how these three viral pathologies are affecting, shows better data for the first week of November this year (week 44) than last year, despite the detection of circulating RSV in hospitalized children. The positivity rate “increased more significantly.”
From October 30 to the 5th of this month, the global number of ARI cases per 100,000 inhabitants was 422.8, while the number of cases in the inter-annual comparison of acute respiratory infections registered in primary care was 455 per 100,000 inhabitants. While there were 10 cases per 100,000 inhabitants in hospital settings, it was 15.7 in the same week in 2022. Pérez noted that the incidence of the triple epidemic is expected to be different from the previous year and “will gradually increase,” with “very clear” flu peaking around Christmas and unusually high RSV activity. This is quite normal if you consider that in addition to lower immunization rates, the use of masks has also decreased significantly. “As a society, the need to get vaccinated and, at some point, use masks is unique. It’s not common right now, but it’s the exception.”
10,000 preventable deaths
The 2017 influenza killed approximately 15,000 people. Another 10,000 cases could be avoided thanks to vaccination. The professional explained that, along with the coronavirus, it remains “one of the biggest pathogens” and asked us not to let down our guard against these seasonal diseases. In fact, the coronavirus remains the leading cause of death in our country, with 31,559 people dead despite a 20% decrease compared to 2021.
Professionals call for greater political leadership and awareness
In this regard, Quilic urged an “important call” for vaccination strategies. In other words, there must be “a strong political leadership committed to the health of the population”, which is where Spain holds the EU Council Presidency until December 31. He concluded that the period of “definition” is to understand “where immunization policy is headed,” he noted at a recent conference organized by the Gaspar Casal Foundation.
those that already exist and those that are to come
GSK. Alberto Clemente, GSK’s Spanish vaccine area director, commented on the biopharmaceutical company’s launch of new vaccines in this immunization program and on its RSV vaccine for the elderly. “We are waiting for the Spanish government’s future decision,” he said. It can be adopted by the authorities,” he noted. In the meantime, they are conducting a Phase III trial to vaccinate adults aged 50 to 59 years at risk of LRTD. If this group also has comorbidities (asthma, chronic obstructive pulmonary disease lung disease, cardiovascular disease…), the risk of RSV-related exacerbations, serious complications, hospitalization, and even death is higher.
MSD. Joaquín Mateos, executive director of MSD Healthcare in Spain, explained that the American pharmaceutical company is also preparing another monoclonal antibody (Phase III) for the prevention of RSV infection in the pediatric population. The goal is to cover children for the entire season with one dose of vaccine, he added. This is especially true in children under the age of two, an age when “almost everyone” becomes infected with RSV and causes a significant burden of disease and hospitalization. In adults, it has developed a combination dose that is in the final stages of study.
Sanofi. The two main vaccines that work against respiratory infections are the high-load anti-influenza vaccine and the vaccine related to RSV in infants. Regarding the first question, Ignacio Sáez-Torres, General Manager of Spain’s Sanofi Vaccine Company, detailed that Galicia has launched an active campaign targeting the 65 to 79 age group. Studies to show its effectiveness in reducing hospitalizations for influenza or pneumonia. Longer term, the company’s strategy is to immunize the elderly with a combination of RSV, human metapneumovirus (hMPV) and parainfluenza (PIV).
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