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Vaccine 'urgently needed to tackle respiratory syncytial virus'

Friday May 20th 2022

A vaccine for respiratory syncytial virus is urgently needed because the infection is responsible for more than 100,000 deaths in young children a year, experts say today.

Authors of a new paper, published in today's edition of *The Lancet*, say RSV is estimated to cause one in 50 deaths among children under five, and one in 28 deaths in babies under six months.

RSV is responsible for about 3.6 million hospital admissions every year and in 2019, the acute lower respiratory infection was attributable to more than 100,000 deaths in children under five in 2019, with more than 45,000 of these being babies under six months old.

Almost all - 97% - of these RSV deaths were in low- and middle-income countries and the study authors say it highlights the urgent need to develop effective RSV vaccines and strategies that prioritise the most vulnerable groups.

Co-author Professor Harish Nair, chair of paediatric infectious diseases and global health at the University of Edinburgh, said: "RSV is the predominant cause of acute lower respiratory infection in young children and our updated estimates reveal that children six months and younger are particularly vulnerable, especially with cases surging as Covid-19 restrictions are easing around the world and the majority of the young children born in the last two years have never been exposed to RSV (and therefore have no immunity against this virus).

"With numerous RSV vaccine candidates in the pipeline, our estimates by narrower age ranges help to identify groups that should be prioritised, including pregnant people, so that children in the youngest age groups can be protected, similarly to current strategies which offer vaccines for whooping cough, typhoid, and tetanus to pregnant people."

A 2015 study found there were 33.1 million annual cases of RSV in children up to five years old, which resulted in 118,200 deaths.

The new figures for 2019 include modelling data from more than 100 new studies, which enabled the researchers to provide estimates for narrower age groups, including from 28 days to six months old.

They found there were 33 million RSV-associated acute lower respiratory infection episodes in children under five years old, which led to 3.6 million hospital admissions, 26,300 in-hospital deaths, and 101,400 RSV-attributable deaths overall.

For babies under six months old, there were 6.6 million RSV-associated acute lower respiratory infection episodes globally in 2019, leading to 1.4 million hospital admissions, 13,300 hospital deaths, and 45,700 overall deaths.

Xin Wang, co-author of the study from Nanjing Medical University, China and University of Edinburgh, added: "Our study estimates that three-quarters of RSVs deaths are happening outside of a hospital setting. This gap is even greater in LMICs, especially in children under six months old, where more than 80% of deaths are occurring in the community.

"This reflects the fact that access and availability to hospital care are still limited in these regions. Early identification of cases in the community and referral for hospital admission of sick children (particularly those with low oxygen saturation in peripheral blood), and universal effective and affordable immunisation programmes will be vital going forward."

Li Ym Wang X, Blau DM et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. *The Lancet* 20 May 2022

[abstract]

Tags: Flu & Viruses | Respiratory | World Health

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