Potential impact of maternal vaccination on life-threatening respiratory syncytial virus infection during infancy

Age‐specific incidence rates and risk factors for respiratory syncytial virus‐associated lower respiratory tract illness in cohort children under 5 years old in the Philippines

“…Fast breathing is one of the criteria for LRTI, and the cut-off points differ by age (50 breaths/min in children aged 2-11 months and 40 breaths/min in children aged 12-59 months 25 [11,42] 19 [11,30] 16 [10,23] 12 [6,17] 18 [10,27] 15 [9,22] 19 [10,31] Age in months, n (%) 2-5…”

“…For these reasons, it is believed that natural maternal immunity is not enough to prevent severe RSV‐LRTI in early infancy. Different strategies for vaccination, including maternal vaccination and infant vaccination, have been proposed to prevent severe infection . However, effective implementation of these strategies depends on understanding the epidemiological patterns of severe infections, including age‐specific incidences.…”

Integrating epidemiological and genetic data with different sampling intensities into a dynamic model of respiratory syncytial virus transmission

“…Virus isolates can be classified into two antigenically and genetically distinct groups (RSV-A and RSV-B) and consecutive seasons are not only characterized by a change in the dominant group, but also changes to the genotype composition [12,13]. Though several studies have predicted a maternal vaccination would be effective [14][15][16] by extending the duration of protection by passive immunity early in life, the vaccination of older children has also been theorized as an effective alternative or complementary strategy by producing a heard immunity effect [17][18][19][20]. Elder and, particularly, school going children have been shown in previous work to be associated with increased risk of infant (sibling) infection [21][22][23][24] -though no direct infection link between the older siblings and the infant was confirmed -and have been identified as drivers of the initial epidemic phase [25].…”

Respiratory Syncytial Virus-related Death in Children With Down Syndrome

“…This implies that maternal vaccination may not sufficiently protect all children with DS against life-threatening RSV infection, given the fact that the level of maternally acquired RSV-specific antibodies declines over time after birth and will only provide temporary protection. 17 , 38 , 39 As an alternative to palivizumab, which requires multiple dosing during the RSV season and is therefore costly, an extended half-life monoclonal antibody has been developed (nirsevimab, previously MEDI8897). This highly potent antibody has shown promising results in a phase IIb trial and was recently granted Breakthrough Therapy Designation by the United States Food and Drug Administration.…”

“…For this, information on age distribution and clinical manifestations of RSV-related mortality is of major importance. 16 , 17 Data on global RSV-related mortality in children with DS are absent. The aim of this study was to describe demographic and clinical characteristics of children with DS who died in hospital with RSV-confirmed infection younger than 5 years of age.…”