New Delhi: New Delhi: Massachusetts based pharma and biotechnology company Moderna announced last week that the US Food and Drug Administration (USFDA) has approved its mRNA-based vaccine mRESVIA to protect adults aged 60 years and above from respiratory tract disease caused by respiratory syncytial virus (RSV).
This is the third approved vaccine against RSV, a highly contagious seasonal respiratory virus and a leading cause of lower respiratory tract infections and pneumonia that causes a particularly large burden of disease in infants and older adults.
RSV is a major global health concern, causing millions of outpatient visits, hospitalisations, and even deaths each year. While most cases present with mild cold-like symptoms, RSV can also progress to lower respiratory tract infections, leading to hospitalisation and potentially causing death in a large number of those affected.
In 2023, the USFDA had approved two other vaccines against RSV — Arexvy by the UK-based pharmaceutical giant GlaxoSmithKline for people aged 60 years and above, and Abrysvo by Pfizer for pregnant women to protect infants.
But the approval for mRESVIA for RSV is the first time that an mRNA vaccine — a type of vaccine that uses a copy of a molecule called messenger or mRNA to produce an immune response — has been approved for a disease other than Covid-19.
This development could be crucial for a country like India where RSV is considered a major public health challenge.
ThePrint had earlier reported that a working group under the country’s apex immunisation advisory body had been constituted to consider the possibility of introducing a vaccine against RSV for infants and toddlers under the age of 2 as part of the Centre’s Universal Immunisation Programme (UIP).
Paediatricians say that babies less than 6 months old, premature infants and those with other medical conditions can develop severe RSV infection or bronchiolitis and may have trouble breathing, requiring hospitalisation.
Some studies have estimated that RSV is the leading cause of hospitalisation for infants under the age of 1 in India.
Dr Dhiren Gupta, a senior paediatrician with expertise in pulmonology, associated with Sir Ganga Ram Hospital, for instance, said that during the active season — from October to March — almost 30 percent of viral bronchiolitis cases that require intensive care are due to RSV infection.
But complications are seen in some other age groups too.
In older children and adults without comorbidities, repeated upper respiratory tract infections are common as well and range from subclinical infection to symptomatic upper respiratory tract disease.
Additionally, the pathogen is increasingly striking the elderly harder, many of whom get severe illness due to the virus. The World Health Organization (WHO) says that in addition to the pediatric burden of disease, RSV is increasingly being recognised as an important pathogen in older adults, with infection leading to an increase in hospitalisation rates among those aged 65 years and above.
Against this background, experts feel that vaccinating young children under 12 months old, older adults, and pregnant women could be a powerful tool in preventing severe RSV infections in a country such as India.
This, they say, could help prevent lung involvement, hospitalisation, and even death associated with the pathogen.
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‘Potential game-changer’
Gupta explained that severe RSV lower respiratory tract infection in infants can be prevented either by administering monoclonal antibody products — such as Nirsevimab, which will likely be available in India later this year — to infants and young children, or by administering RSV vaccine during pregnancy.
Some other specialists ThePrint spoke with underlined that RSV lives up to its name, targeting the respiratory system and affecting people of all ages but the outcomes can be disproportionately negative for those most vulnerable.
“Young infants, older adults and individuals with chronic health conditions are particularly vulnerable to severe RSV illness. These chronic conditions include heart, lung, liver and kidney diseases, weakened immune systems, neurological disorders, and diabetes mellitus and frail individuals are particularly at higher risk,” Dr Vikas Maurya, senior pulmonologist with Fortis Hospital in New Delhi, said.
Maurya said that an RSV vaccine could be a game-changer for countries like India, which are disproportionately affected by this virus.
Crowded living conditions facilitate the spread of RSV, resulting in a high number of infections, hospitalisations, and deaths, according to the pulmonologist, while widespread testing for the pathogen is not readily available in India.
“This lack of diagnostic tools further emphasises the importance of an RSV vaccine. Vaccines currently used in many European and Western countries could significantly benefit the Indian population,” Maurya said.
(Edited by Zinnia Ray Chaudhuri)
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