RSV Vaccines to Protect Newborns, Young Children, and the Elderly
The development of the RSV, Respiratory Syncytial Virus, Vaccine to protect newborns and the elderly is one of Science Magazine’s ten Breakthroughs of 2022. We update this to the recent FDA approval, and cover the effects of RSV and the need for the vaccine.
Newborns for up to six months are covered if the vaccine is given to mothers late in their pregnancy. It can prevent RSV caused inflammation of the airways in the lungs of newborns. For children under 5, 58,000 to 80,000 a year are hospitalized in the US from RSV. Globally, it causes 100,000 to 200,000 infant deaths a year.
For the elderly over 60, RSV can worsen lung and heart conditions and also attack those with weakened immune systems. For those over 65, RSV strikes and hospitalizes 60,000 to 120,000 a year, and causes 6,000 to 10,000 deaths a year.
The breakthrough in the vaccine was to use the pre-cell fusion RSV glycoprotein, the F protein, and prevent it from fusing with the cell which it would infect. This allows it to trigger much more antibody production. The research was carried out by the NIAID agency, headed by Dr. Fauci.
The RSV vaccine called Arexvy, which was developed by GSK, GlaxoSmithKline, was approved for those over 60 by the FDA on May 3, 2023, and may be approved by the CDC in early June. It may be distributed starting in August, before the usual Fall and Winter seasons of infection. Arexvy prevents lower respiratory track disease (LRTD), which causes pneumonia and bronchiolitis, the swelling of small airway passages in the lungs. In trials, Arexvy reduced the risk of symptomatic LRTD by 82.6%, and of severe LRTD by 94.1%.
On May 18, 2023, the Pfizer Vaccine for RSV was recommended for approval for infants by the FDA advisory committee. The full FDA decision on it is expected by late August. Its trials showed effectiveness against severe respiratory illness for those younger than three months of 81.8%, and for those under six months of 69.4%. Essentially all children get RSV by the age of two.
The vaccines may be effective for a year.
The distribution to the global South requires multivial containers, preservatives, cold chain stability, and clinical trials. Fears are that it might require as long as seven years to do accomplish this, as has been the delay in other cases.
