RSV: Infants prioritised for new respiratory virus vaccine ahead of older adults

Young children are being prioritised before older adults for access to new vaccines that protect against a common respiratory virus.

Every winter, thousands of people are hospitalised with respiratory syncytial virus (RSV), but newly developed vaccines promise to greatly reduce this annual disruption.

Last autumn, the National Immunisation Advisory Committee recommended vaccination against RSV for infants and people aged 65 and over, but said further analysis was needed of the cost effectiveness of the vaccines that have just come on the market.

The Department of Health then decided to ask the Health Information and Quality Authority to carry out health technology assessments (HTAs) of RSV vaccination for the two groups.

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The Department’s chief medical officer, Prof Breda Smyth, asked Hiqa to carry out a rapid HTA of infant immunisation against RSV, to be followed by a full HTA covering infants and older people.

This means vaccination of infants against the virus is likely to be in place in time for next winter, while the introduction of vaccination of older adults will take longer.

[ How do I know if I have Covid, flu, RSV or just a cold? ]

Asked why it was fast-tracking the vaccination against RSV of young children, the Department said this group experienced the highest number of hospitalisations last winter, and this had a “significant impact” on the capacity of children’s hospitals.

“In line with previous years, the highest rates of notified cases of RSV and those requiring hospitalisation were recorded in those aged less than one year old, followed by the one to-four-year age group,” a spokesman said.

“By prioritising the HTA for infants the Department wishes to ensure that there is an evidence base for implementation of an immunisation programme, as early as possible, for the group where the burden of disease is most significant.

“The outcome of the full HTA can inform the development of the RSV immunisation programme, including what, if any, other age groups should be offered a vaccine.”

Ireland does not count RSV deaths, but across Europe the virus is estimated to lead to about 20,000 deaths and 270,000 hospitalisations in older adults each year. One US study found that one-third of older patients hospitalised with RSV died within the year.

[ New antibody treatment for RSV in infants highly effective in reducing hospitalisations ]

In the 2022-23 season, there were 7,559 cases of RSV reported in Ireland, of which 2,231 were in adults aged over 60. So far this winter, 3,175 people have been hospitalised with the virus, including 1,387 children under one and 508 over-65s.

The assessment of immunisation against RSV in children, which was specifically requested by the chief medical officer, will inform a decision for one season , said Hiqa. A full HTA of immunisation in children and adults will start later this year and will inform a decision on whether to change the national immunisation programme.

An assessment of the cost effectiveness of vaccinating against shingles will also be carried out by Hiqa this year. In the UK, this vaccine is available free to over-65s.

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