RSV: Paediatricians call on government to expedite infant vaccination programme

Procurement and delivery

In the UK the RSV epidemic peaks each December and causes around 33 500 hospital admissions in children under 5 every year. It is linked to 20-30 childhood deaths a year.

Rolling out an RSV vaccine to infants could result in 108 000 fewer GP consultations, 74 000 fewer emergency department visits, and 20 000 fewer admissions solely in children aged under 1, the letter says. These figures are based on modelling by the JCVI.2

“Every year our child health services grind to a halt with high levels of RSV and other winter bugs. We now have an opportunity to turn the tide on this trend,” said Camilla Kingdon, president of the Royal College of Paediatrics and Child Health.

An RSV immunisation programme “would be an absolute game changer,” she said. “We simply cannot have another winter like the last. The chancellor and health secretary are staring a no-brainer in the face—they must heed the advice of doctors. Together with 2000 of my colleagues, I urge them to seize this opportunity and not wait until after the upcoming election. RSV won’t wait.”

Ian Sinha, consultant respiratory paediatrician and member of the Asthma + Lung UK Council of Healthcare Professionals, said, “The lack of government action following the JCVI’s recommendation for a vaccination programme is a blow to children and young people in the UK, who already have worse respiratory outcomes than those in other rich countries.

“We need swift and decisive action now to ensure there is time to implement this programme in the autumn. Delaying further will complicate procurement and delivery, leaving thousands of infants needlessly vulnerable to this dangerous infection next winter.”

Maternal immunisation

Nirsevimab (Beyfortus), a long acting monoclonal antibody for passive immunisation against RSV infection, was licensed by the UK Medicines and Healthcare Products Regulatory Agency in November 2022. A study of more than 8000 infants showed that nirsevimab, developed by Sanofi in partnership with AstraZeneca, reduced RSV associated hospital admissions in infants by 83%.34

Abrysvo, a bivalent maternal vaccine developed by Pfizer, was also approved by the agency in November 2023. It is intended for use by pregnant women to protect their infants, as well as for adults over 60. Last year experts called for further analysis of trial data and post-approval monitoring of the maternal RSV vaccine after the drug company GSK’s trials of a similar product were halted over a rise in preterm births and neonatal deaths.5

The JCVI has said that it has no preference whether a maternal vaccination or a passive immunisation programme should be chosen to protect infants from RSV. It indicated a preference for a year round offer for a passive immunisation or maternal immunisation programme, to help ensure high uptake and because it would be simpler to deliver than seasonal campaigns.3

A spokesperson for the Department of Health and Social Care said that the government was working with the UK Health Security Agency and NHS England to explore the potential for an RSV vaccine programme for infants and older adults and that a decision would be made in the coming months.