2023-08-25 08:02:14
Bronchiolitis, caused by the respiratory syncytial virus (RSV), affects 30% of infants under 2 years of age in France each year. The virus can also cause sometimes serious respiratory infections in the elderly. In recent years, research and development efforts have borne fruit in making vaccines against RSV infections available. From this fall, all infants could be protected by the arrival on the market of a new antibody! Explanations.
An RSV vaccine for pregnant women and the elderly
It front of infections caused by RSV, several preventive solutions have been developed in recent years and are gradually being authorized on the American and European market. These solutions are vaccines or monoclonal antibodies (specifically targeting virus proteins), which are intended:
either to infants affected by winter epidemics of bronchiolitis ; or to the elderly, who can also develop serious infections.
Let’s start by presenting the vaccines. A first vaccine received a favorable opinion from the European Medicines Agency (EMA) on July 20, 2023. This vaccine is the first anti-RSV vaccine that could be available in Europe, once the European Commission has given its authorisation. This vaccine, administered in an intramuscular dose, makes it possible to immunize:
people aged at least 60 for the prevention of lower respiratory tract infections (pneumonia) caused by RSV; pregnant women and therefore by passive immunization infants from birth to 6 months. By vaccinating pregnant women, maternal antibodies pass into the placental blood and help protect the infant during the first months of life. Read also – April 24 to 30, 2023: European Vaccination Week
One, then two monoclonal antibodies against bronchiolitis
Along with vaccines, researchers have developed monoclonal antibodies specifically targeting virus proteins to protect infants from bronchiolitis. As early as 1999, a first monoclonal antibody (palivizumab) neutralizing RSV was placed on the European market, but it was reserved for premature infants (born before 35 weeks of pregnancy) or infants at high risk for severe RSV infection :
Infants under 2 years of age who have required treatment for bronchopulmonary dysplasia (chronic pneumonia in newborns often following the use of prolonged ventilation) within the last 6 months; Children under 2 years of age with congenital heart disease with haemodynamic repercussions.
Since the end of 2022, this first monoclonal antibody had been joined by a second (nirvesimab), indicated this time for the protection of all infants during their first year of exposure to the virus. With a European marketing authorization (AMM), this antibody was waiting for the green light from the French health authorities to be available before the start of the next winter epidemic. The General Directorate of Health had announced a decision for this summer 2023, and the High Authority for Health (HAS) has just published its favorable opinion on August 2, 2023. This antibody will therefore be available from September 2023 to protect patients. infants from bronchiolitis.
Read also – Bronchiolitis: a vaccine from 2023?
Towards the end of bronchiolitis epidemics?
In its opinion, the HAS distinguishes between two situations:
Infants at high risk of serious infection, who were already eligible for the first antibody available: HAS recommends using the new antibody as a priority during their first year of exposure to RSV; Infants without particular risk, who until then could not be protected against RSV: HAS recommends the new antibody in all infants during their first year of exposure to RSV to prevent bronchiolitis.
This new antibody should be available from September in pharmacies and it will be reassessed after one year by the health authorities according to its impact on the winter bronchiolitis epidemic 2023-2024. In practice, the antibody is injected intramuscularly once and protects the infant for at least 5 months. Infants born between October 2023 and March 2024 will be able to receive the dose before leaving the maternity ward. Infants under the age of 1 born before October 2023 will be able to receive the dose from the doctor or pediatrician. For more information, ask your doctor or pharmacist for advice. The impact of these new methods of preventing RSV infections on the winter epidemic of bronchiolitis will of course be closely monitored…
Read also – A flu diagnosis in just 20 minutes
Estelle B., Doctor of Pharmacy
Sources
– AREXVY. Laboratory: GSK Vaccines. www.mesvaccins.net. Accessed August 1, 2023.
– DGS-Urgent: possibility of prescribing nirsevimab (prevention of RSV bronchiolitis) if the HAS opinion is favourable. www.ordre.pharmacien.fr. Accessed August 1, 2023.
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