COVID-19 has stolen the limelight from other respiratory viruses in recent years. However there are plenty of other common viruses which can have serious health consequences, among them Respiratory Syncytial Virus, or RSV.

RSV is extremely common, infecting an estimated 64 million people globally each year, and killing around 160,000 of them¹. By comparison, influenza kills between 290,000 and 650,000 per year².

Primarily affecting the lungs and upper respiratory passages, RSV is typically mild when experienced by healthy adults. However, its impact can be more severe for children under five and the elderly. It’s therefore extremely encouraging that vaccines and treatments are emerging which can be used in each of these age groups.

In the US, the Food and Drug Administration (FDA) has awarded approval to the first RSV vaccine for over-60s, which is already available in American pharmacies, with wider approvals expected in the coming months. This vaccine, Arexvy, has been produced by GSK, but another candidate from Pfizer (Abrysvo) also recently secured approval. What’s more, a third candidate from Moderna recently has shown promise in late stage trials. The RSV vaccine market presents pharmaceutical companies with an estimated annual $10bn opportunity, so perhaps it is no surprise there is such a healthy pipeline.

For infants, the most successful treatment candidates so far have been antibodies, not vaccines. Most notably an antibody known as nirsevimab, given preventively as a single-dose, recently received authorisation in both the US and UK. Trials showed this drug reduced the risk of severe infection by around 70% compared to placebo. One vaccination intended for expectant mothers is also awaiting approval.

RSV is endemic and never likely to be eliminated. However, together, these products are expected to materially improve outcomes for those affected.

References

1. Respiratory Syncytial Virus (RSV) | NIH: National Institute of Allergy and Infectious Diseases
2. COVID-19 vs. the Flu | Johns Hopkins Medicine – note how broad the estimates are even for influenza, which is typically among the better-tracked viruses. Many deaths involving respiratory viruses, especially among the elderly, never involve formal diagnosis. Instead estimates employ modelling techniques, serological studies and surveillance data. The end result typically has a large margin of error.

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