What Pfizer's maternal RSV vaccine means for the infant population

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Tina Tan, MD, FAAP, FIDSA, FPIDS, discusses what Pfizer's recently FDA-approved RSV vaccine means for infants ahead of the traditional RSV season.

This interview is part 2 of a 3-part series highlighting RSV ahead of the traditional RSV season. Click here for part 1, and click here for part 3.

In this Contemporary Pediatrics® interview, we continue our coverage of the FDA-approved maternal RSV vaccine from Pfizer with Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago. Tan discusses how this can change the treatment landscape for infants with RSV disease, while reminding healthcare providers to continue the push for routine vaccinations in their patients this fall.

Transcript (edited for clarity):

Contemporary Pediatrics®:

Thank you for visiting Contemporary Pediatrics®, I'm editor Joshua Fitch. Joining us today is Dr. Tina Tan, editor in chief of Contemporary Pediatrics and a pediatric infectious diseases attending at Ann & Robert H. Lurie Children's Hospital in Chicago. Dr. Tan, thank you for joining us. The FDA has approved Pfizer's bivalent RSV vaccine delivered through maternal immunization ahead of the traditional RSV season. What is your initial reaction now that another player has stepped in, alongside the recently FDA-approved nirsevimab?

Tina Tan, MD, FAAP, FIDSA, FPIDS :

I think it is fabulous. It really is. We know that RSV is the leading cause of lower respiratory tract disease in infants, and we know that the peak of disease is usually within the first three months of life. So having this vaccine licensed for use in pregnant women is absolutely wonderful. I mean, from the trials, we know that vaccine effectiveness was 82% during the first 3 months of life and preventing lower respiratory tract, medically attended disease, and it was still almost 70% effective during the first 6 months of life, and we know that's when the vast majority of severe RSV cases occurs, resulting in hospitalization and unfortunately, in some instances, deaths. So, this is absolutely fabulous news.

Contemporary Pediatrics:

Thank you, Dr. Tan. This approval follows the recent FDA approval of nirsevimab, a monoclonal antibody, can you talk about what this means to have 2 preventative options ahead of the traditional RSV season, and would you say it's kind of unprecedented?

Tan:

It definitely is unprecedented. Nirsevimab can be used in older infants and children that have underlying conditions that place them at a higher risk for RSV disease. So, I think it's great that we now have more tools in the toolbox to basically protect these young infants against RSV disease.

Contemporary Pediatrics:

Thank you, Dr. Tan. Several pediatricians, we have spoken to regularly regarding RSV have explained the intensity and severity of infection that these babies have to go through. Talk about this natural, downstream effect both treatments will potentially have, specifically Pfizer's maternal vaccine.

Tan:

Pfizer's maternal vaccine, the mom gets the vaccine, but the mom passes antibodies through the placenta to the baby, so the baby will be much more protected against getting RSV disease. Even if the baby got RSV disease, it definitely should be much milder than if they got the disease with no antibodies on board. Similarly with the monoclonal antibody, if they were to be exposed to RSV disease, and got the disease, it definitely should be much milder.

Contemporary Pediatrics:

Can you elaborate at all on how this vaccine will help with symptoms specifically? Just through patients you've seen, talk about just the relief, and the relief for parents and pediatricians treating these patients.

Tan:

The severity of the respiratory symptoms should definitely be much less with either maternal vaccination antibodies on board or the baby actually getting the monoclonal antibody themselves. It really is the severe respiratory symptoms, the need for oxygen, etc., that is what keeps these kids in the hospital. These babies might have a little bit of like a runny nose or a cough, but hopefully they're not requiring oxygen or having severe wheezing as they might have if they did not have any antibodies on board.

Contemporary Pediatrics:

Thank you, Dr. Tan. Anything else you would like to add or have general health care and pediatric health care professionals keep in mind now that this has been approved by the FDA?

Tan:

I think this is absolutely fabulous, but also just want to remind everybody that all infants and children should be getting their routine vaccinations and that includes influenza vaccine in anyone 6 months of age and older because the symptoms of RSV, influenza and COVID-19 all overlap and so influenza and COVID-19 vaccine should also be given along with maybe the monoclonal antibody. Reminder to really talk to your OB/GYN colleagues about the importance of giving maternal vaccination.

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