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Respiratory syncytial virus prevention in infants and equity in Latin America and the Caribbean: from evidence to action

Year: 2025

Type: article

Abstract: Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract illness in infants worldwide, responsible for more than 100,000 deaths annually in children under five, most of them in low-and middle-income countries.1 In Latin America and the Caribbean (LAC), where the majority of disease likely occurs in the community, RSV-associated bronchiolitis and pneumonia are also important causes of pediatric hospitalization, indication for oxygen therapy, and admission to intensive care units. 2 The burden of morbidity and mortality is highest among the most vulnerable: preterm infants, children with underlying chronic diseases or altered immunity, and those living in disadvantaged or remote areas.[1][2][3] The recent availability of two highly effective prophylactic strategies, maternal vaccination during pregnancy (RSVpreF bivalent vaccine) and long-acting monoclonal antibodies (nirsevimab and clesrovimab) administered to infants from birth through the first months of life, represents a historic opportunity to prevent severe RSV disease in the region.[4][5][6] However, their implementation must be framed within the principles of the children's right to health and guided by a strong commitment to equity and health justice.LAC is becoming a reference region for RSV prevention, with countries adopting diverse strategies adapted to local contexts.Chile implemented a universal approach with monoclonal antibodies, protecting all newborns with a dose at birth, infants under six months of age as a catch-up dose, and high-risk children up to two years of age, with clear public health impact and broad community acceptance.5 Argentina prioritized maternal vaccination as its main strategy, showing effectiveness in preventing hospitalizations and severe disease consistent with the efficacy reported in prelicensure clinical trials and a more modest effect on healthcare utilization.4 Paraguay introduced monoclonal antibodies at birth and in the first months of life

Source: The Lancet Regional Health - Americas

DOI: 10.1016/j.lana.2025.101316

Authors: María L. Avila-Aguero, Luiza Helena Falleiros-Arlant, José Brea, Carlos Espinal, Flor Muñoz

Institutions: Hospital Nacional de Niños, Universidade Metropolitana de Santos, Instituto Tecnológico de Santo Domingo, Florida International University, Texas Children's Hospital

Language: English

Topic: Respiratory viral infections research

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $4,930