The path to equitable respiratory syncytial virus prevention for infants: challenges and opportunities for global implementation
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
The approval for a respiratory syncytial virus (RSV) maternal vaccination programme by Gavi, The Vaccine Alliance, marks substantial progress toward equitable access, with important work still to come. Several countries, most of which are high-income, have introduced RSV immunisation either using a vaccine containing the RSV fusion protein in its prefusion conformation, which is given to pregnant people in late pregnancy, or by using a long-acting monoclonal antibody (mAb) administered directly to infants. Post-implementation real-world effectiveness data show a major impact in reducing medically attended RSV-lower respiratory tract illness and hospitalisation using either strategy. Although RSV poses a substantial burden to infants and vulnerable children worldwide, 97% of associated mortality occurs in low-income and middle-income countries. However, few of these countries have authorised and introduced RSV preventive strategies. This Review outlines the challenges and opportunities for expanding access to RSV prevention for infants in resource-restricted settings guided by WHO's Immunization Agenda 2030 and the UN's Leave No One Behind framework for non-discriminatory sustainable development. We discuss burden, vaccine and mAb development, health economics and impact modelling, policy, implementation and programmatic considerations, surveillance, and awareness as key RSV domains. This Review summarises recent advances in research and highlights the urgent steps needed to ensure equitable access to RSV prevention for all infants worldwide.
Date Issued
2025-12-01
Date Acceptance
2025-11-01
Citation
The Lancet Global Health, 2025, 13 (12), pp.e2165-e2174
ISSN
2214-109X
Publisher
Elsevier
Start Page
e2165
End Page
e2174
Journal / Book Title
The Lancet Global Health
Volume
13
Issue
12
Copyright Statement
© 2025 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41197645
PII: S2214-109X(25)00379-1
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2025-11-03