Strategies to prevent severe Respiratory Syncytial Virus (RSV) infections in infants the Belgian expert opinion : The Belgian expert opinion

Abstract

Respiratory syncytial virus (RSV) causes a significant burden of disease in children, particularly in young infants or those with comorbidities. Recently, two new effective options have been approved for the prevention of RSV-related lower respiratory tract disease in infants: a long-acting monoclonal antibody (nirsevimab, Beyfortus®) and a maternal vaccine (RSVpreF; Abrysvo®). A Belgian group of paediatric RSV experts (members of the Belgian Society of Paediatrics) recommends an immunization strategy targeting all infants aged <1 year, at the start of their first RSV season and infants with risk factors aged <2 years at the start of their second RSV season. The choice of one or a combination of these two complementary preventive options will depend on maternal and infant factors, taking into account the advantages and disadvantages of potential strategies, as well as costs and reimbursement. The expert group recommends a low cost to parents and rapid reimbursement to avoid health inequalities. Adequate supply should also be ensured. Implementation should include data collection to conduct a real-world observational survey of effectiveness over the first 5 years of use. Awareness campaigns need to be organised for all stakeholders.