Scientists might have solutions to a deadly respiratory disease, originally discovered in Baltimore in 1957, yet speculated to have existed for thousands of years as told commented by Jim Boonyaratanakornkit, a virologist and transplant immunologist at the Fred Hutchinson Cancer Centre in Seattle. The illness is caused by the respiratory syncytial virus, not the flu or COVID-19.
People 60 and older may soon receive some anti-virus protection in Europe. On April 26, an advisory committee made the case for the use of an RSV vaccine produced by the multinational pharmaceutical company GSK. The European Commission will review and approve that choice in the end.
An overview
Respiratory and respiratory tract infections are brought on by the respiratory syncytial virus (RSV). Most kids have the virus by the time they age two because it is so widespread. Adults can contract the respiratory syncytial (sin-SISH-ul) virus.
RSV symptoms are often mild and similar to those of the common cold in adults and older, healthy children. The majority of the time, taking care of oneself is sufficient to alleviate any discomfort. RSV can cause serious infection in some people, including infants aged 12 months or less (newborns), especially preterm infants, older adults, persons with heart or lung problems, and people with low immune systems (immunocompromised).
History of Vaccination
In the US, there is no licenced RSV vaccination. There are also no particular antiviral drugs to treat RSV, and the only preventive medicine available is a monoclonal antibody, which is only given to a small number of infants who are at a high risk of developing serious illness. However, that might soon alter. Clinical trial evidence from a number of businesses currently suggests that their various vaccine candidates or lab-made monoclonal antibodies can guard against the severe effects of RSV.
The youngest children are a focus of several of those treatments. The virus can infect people of any age, although it usually affects children the most severely. RSV is thought to have infected 33 million kids ages 5 and under in 2019 worldwide.
To protect newborns and children from RSV, other businesses are creating monoclonal antibodies. Despite a dose given before the start of the RSV season may help protect weak babies from developing serious illnesses if they contract the illness, these laboratory-produced antibodies do not qualify as vaccinations.
Janssen Pharmaceuticals has decided to withdraw its RSV (respiratory syncytial virus) program and halt a late-stage clinical trial due to the company’s focus on unmet medical needs and the evolving RSV landscape, according to Penny Heaton, the company’s global therapeutic area head for vaccines. The decision was made in March and marks a shift in the company’s portfolio.
Outbreak post 2020
Respiratory syncytial virus (RSV) almost vanished in the winter of 2020-21 due to COVID-19 precautions such as social distancing and mask-wearing. However, the virus rebounded in the summer of 2021, with a season that started in May and ended in January 2022. The 2022-23 season saw a positivity rate of 19 percent, hitting kids hard and overwhelming children’s hospitals in some areas. Although it is unclear when the next RSV season will begin, vaccines and treatments in development could be available this fall to reduce the number of doctor visits, hospitalizations, and deaths from RSV infections.
What’s within the vaccine?
The vaccines developed by Pfizer, GSK, and Moderna for respiratory syncytial virus (RSV) use a stabilized form of the F protein, which is a shapeshifter that helps the virus fuse with human cells. Bavarian Nordic’s approach involves engineering a live attenuated vaccinia virus to produce five of RSV’s proteins, including the F protein. Codagenix uses the RSV virus itself, with over 1,000 mutations in one gene to make the virus unable to cause disease, and plans to test the vaccine’s safety in healthy 5-year-olds. Pfizer’s vaccine is being tested for its ability to protect newborns, babies, and older adults, while the other vaccines are for use in older adults.
How the vaccine work for younger populations
Pfizer has tested a vaccine candidate for RSV in pregnant women, with the aim of transferring antibodies to their babies to protect them from the virus in the first six months of life. The vaccine had an efficacy of 81.8% against severe lung infections in newborns, with the efficacy decreasing to 69% within six months. The vaccine was less effective at preventing less-severe lung infections, with an efficacy of 57% within 90 days after birth. However, the vaccine was effective at preventing hospitalizations, with an efficacy of almost 68% in the first 90 days of life. The vaccine had no serious safety concerns in either mothers or babies. Pfizer is continuing to collect data and aims to present two years’ worth of data ahead of an FDA meeting in August.
Do these antibodies offer any protection to infants and newborns?
Lab-made monoclonal antibodies targeted against RSV’s F protein show promise in protecting infants against the virus. Currently, only one monoclonal antibody, palivizumab, is approved by the FDA for use in babies at the highest risk of severe illness from RSV. However, it is expensive and not widely available in low- and middle-income countries where the virus is prevalent. Sanofi and AstraZeneca have developed a longer-lasting monoclonal antibody called nirsevimab, which was approved for use in Europe and the UK in November. Clinical trials showed that it was 76.8% effective in preventing hospitalization in newborns. Merck is also testing a long-lasting monoclonal antibody, but results are not yet available.
Do immunisations offer protection to old people?
RSV is not just a concern for babies, toddlers, and preschoolers, as it can hit older adults hard too. Between 60,000 and 160,000 older adults in the US alone are hospitalized with RSV each year, and 6,000 to 10,000 die. In high-income countries, an estimated 5.2 million people over 60 caught RSV in 2019, with 470,000 of them hospitalized and 33,000 dying. Pfizer, GSK, Moderna, and Bavarian Nordic have all developed vaccines against RSV, with efficacy ranging from 66.7% to 85.7%. The vaccines may not stop RSV’s spread, but they could protect the most vulnerable against its worst effects.