(beraking latest news) – “After the first winter season, the interim analysis of vaccination against respiratory syncytial virus (RSV) showed a significant difference in preventing episodes of infection and reducing the frequency of severe forms of the disease in the elderly, all ‘increase in comorbidities: it was therefore more effective in populations most at risk of severe infection”. This is how Alberto Papi, Full Professor of Respiratory Apparatus Diseases, University of Ferrara, comments on the results of the study just published in the New England Journal of Medicine (Nejm) on the efficacy of Gsk’s candidate vaccine against RSV (RSVPreF3 OA).
“On a global scale, RSV is relevant in fragile populations – explains Papi – We think of the respiratory syncytial virus as an infection of children – around the age of 2 almost everyone becomes infected and the most relevant clinical form is bronchiolitis – but in reality it is a common respiratory infection and, in the elderly, it is associated with serious complications and, in comorbidities (presence of multiple pathologies, ed), it leads to a worsening of cardiovascular and respiratory conditions with hospitalizations and mortality”.
The objective of the study was to test the efficacy of the Rsv anti-virus “in a population over 60 with immunosenescence – with less effective immunological defenses, due to age – in the first season of inoculation. Were involved – continues the professor – 25 thousand patients, 12 thousand per arm (treated and not), who also had comorbidities “.
Vaccination has turned out to be “one more weapon to reduce the risk of serious illness. The 90% efficacy in those with multiple comorbidities is particularly marked – underlines Papi – because these are ‘unstable’ patients, who can undergo hospitalization with consequences on various parameters, including other future infections and social-health costs. “The Rsv infection- he reiterates – paves the way for a destabilization of fragile patients that we know how it begins, but we don’t know how it can evolve and with what consequences. Preventing an infection is not an option, it must be placed in the order of the possibilities of interventions to be done. In patients with chronic obstructive pulmonary disease (COPD), for example, prevention, including vaccinations, is substantial.”
Returning to the study, the professor highlights another important aspect. “In the very elderly over 70 – he continues – there was the doubt of immunological senescence, i.e. a more reduced response, however, both from the clinical point of view, of prevention of infection, and of immunogenicity, there was a response even in the elderly. On this, I think the adjuvant has played a significant role”.
As Papi recalls, “the attempt to make vaccines for RSV has been going on for more than 60 years with major failures. The research stopped in the 70s”. “It is the first time – he observes – that an effective vaccine with an adjuvant has been obtained for RSV. In fact, we are not there yet in the child. It’s a complicated virus”, unlike what one would expect.
The published data relate only to the first phase of the study, “the first season, and are those presented to the regulatory bodies for authorisation. The study – specifies the expert – continues for another 2 seasons. It must be understood how long the immunization lasts, if boosters are needed and how often. It will also be necessary to understand if and how to combine it with other vaccination strategies, such as for Covid and the flu. There are various trials (clinical studies, ed) underway. I have the perception that, after the Covid experience, the perception of vaccinations in the population has changed profoundly. Unlike years ago – concludes Papi – we have patients asking to be enrolled in vaccine studies ”.