Croup

• The Therapeutic Goods Administration (TGA) has approved a vaccine against respiratory syncytial virus (RSV) in Australia for the first time.
• RSV is a contagious respiratory virus which causes an illness similar to influenza, most notably in babies and older adults.

A bit about RSV

• There are two key groups of people we would like to protect from RSV: babies (up to about one year old) and people older than 60.
• In babies and younger children, RSV generally causes a wheezing asthma-like illness (bronchiolitis), but can also cause pneumonia and croup.

RSV vaccines for older people

• For older adults, there are actually several RSV vaccines in the pipeline.
• The GSK and Pfizer RSV vaccines are similar.
• Both vaccines have been shown to reduce illness from RSV by more than 80% in the first season after vaccination.

Protecting young children from RSV

• To prevent other diseases, this can be overcome by giving multiple vaccine doses over time.
• But the highest risk group for RSV are those in the first few months of life.
• To protect this youngest age group from the virus, there are two potential strategies available instead of vaccinating the child directly.

• Abrysvo, the Pfizer RSV vaccine, has been trialled in pregnant women.
• In clinical trials, this vaccine has been shown to reduce illness in infants for up to six months.
• It has been approved in pregnant women in the United States, but is not yet approved in Australia.

What now?

• RSV, like influenza, is a major cause of respiratory illness, and the development of effective vaccines represents a major advance.
• While the approval of the first vaccine for older people is an important step, many details are yet to be made available, including the cost and the timing of availability.

Allen Cheng receives funding from the National Health and Medical Research Council and the Australian Government. He is a member of the Australian Technical Advsory Group on Immunisation. The views expressed in this article may not reflect those of ATAGI.