The World Health Organisation (WHO) published its first-ever position paper on immunisation products to protect infants against Respiratory Syncytial Virus (RSV).

RSV is the leading cause of acute lower respiratory infections in children globally.

Respiratory Syncytial Virus (RSV)

• Every year, RSV causes about 100,000 deaths and over 3.6 million hospitalisations in children under the age of five years worldwide. 

• About half of these deaths occur in infants younger than six months of age. 

• RSV is an RNA virus that belongs to the Pneumoviridae family along with the human metapneumovirus and consists of two genotypes (A and B). 

• RSV is specific and pathogenic for humans and infects cells along the human respiratory tract, from the nose to the lungs. 

• RSV causes a wide spectrum of respiratory disease, from mild upper respiratory tract infections (in most cases) to life threatening lower respiratory tract infections

• The vast majority (97 per cent) of RSV deaths in infants occur in low and middle-income countries where there is limited access to supportive medical care, such as oxygen or hydration.

• RSV is transmitted via infectious respiratory particles through the air from an infected person to another one. The virus is also thought to be transmitted by direct contact with infected persons or through support contaminated with the virus. 

• RSV usually causes mild symptoms similar to the common cold, including runny nose, cough and fever. 

• However, it can lead to serious complications — including pneumonia and bronchiolitis — in infants, young children, older adults and those with compromised immune systems or underlying health conditions.

• There is no specific treatment for RSV. Management of severe RSV disease involves supportive care, such as nasal suction of secretions, intravenous fluids for hydration, and most importantly supplemental oxygen to help breathing.

• Three vaccines are licensed to prevent severe RSV disease in elderly persons and adults with certain underlying illnesses, like lung and heart disease.

Two immunisation products

Published in the Weekly Epidemiological Record (WER), the position paper outlines WHO recommendations for two immunisation products:

i) A maternal vaccine that can be given to pregnant women in their third trimester to protect their infant.

ii) A long-acting monoclonal antibody that can be administered to infants from birth, just before or during the RSV season.

• The WHO-recommended RSV immunisation products can transform the fight against severe RSV disease, dramatically reduce hospitalisations, and deaths, ultimately saving many infant lives globally.

• In response to the global burden of severe RSV disease among infants, WHO recommends that all countries introduce either the maternal vaccine (RSVpreF), or the monoclonal antibody (nirsevimab) depending on the feasibility of implementation within each country’s existing health system, cost-effectiveness and anticipated coverage. 

• Both products were recommended by the Strategic Advisory Group of Experts on Immunisation (SAGE) for global implementation in September 2024. 

• In addition, the maternal vaccine received WHO prequalification in March 2025, allowing it to be purchased by UN agencies.

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