Prevention of respiratory syncytial virus (RSV) is now a real possibility thanks to the rollout of an immunisation program backed by a decade’s worth of epidemiological research led by The Kids Research Institute Australia.
A respiratory infection common in young children, RSV is responsible for 3.6 million infant hospitalisations and 100,000 deaths globally each year – prompting calls for urgent interventions to stop the virus in its tracks.
Associate Professor Hannah Moore – an epidemiologist from the Wesfarmers Centre of Vaccines and Infectious Diseases, based at The Kids – has been at the forefront of RSV research over the past decade.
With her team, she has built up a bank of crucial evidence to guide the delivery of immunisation and vaccination programs – the first of which arrived in WA this year after the State Government made the approved antibody treatment, Nirsevimab, available free to all WA babies aged under eight months, and some older children.
Associate Professor Moore’s work has provided critical data to inform the $11 million, national-first program’s roll-out, identifying the best immunisation targets – and timing – to ensure maximum impact on RSV rates.
With her team, Associate Professor Moore used hundreds of thousands of WA hospital records to uncover the full extent of the RSV burden on children, families and the healthcare system. In one study published last year, they examined hospital admission patterns for 23,784 WA children aged under eight years who had been admitted to a Neonatal Intensive Care Unit (NICU) between 2002 and 2013.
“Our results found babies born pre-term or with a chronic lung disease and admitted to a NICU had a much higher risk for acute respiratory infections, likely caused by RSV, than babies born full-term or without lung disease,” Associate Professor Moore said.
“These kinds of studies provide the clues that will help guide future RSV immunisation policies to effectively target the most at-risk groups at the best time.”
In other research, the team found babies born in autumn had the highest RSV hospitalisation rates in the first six months of life – enabling health professionals to identify, based on birth month, which children would benefit most from RSV immunisation.
Further work identified that a child’s age at the time of RSV hospitalisation could help predict their later development of asthma and wheeze.
“We found, using 252,287 WA hospital records, that children hospitalised with their first RSV infection between six to 12 months of age had the highest risk of later developing asthma, indicating that an antibody treatment could reduce the risk,” Associate Professor Moore said.
The team also explored the effect of other respiratory vaccines on RSV hospitalisations, with one study finding hospitalisation rates dropped after three doses of the pneumococcal conjugate vaccine.
Separately, they undertook a national online survey to examine community perceptions of RSV.
The survey found participants – especially current parents – had high RSV awareness and were open to immunisation, but found parents were less aware of virus severity and other illnesses associated with RSV, such as pneumonia and bronchitis. The results signalled there was scope for education programs targeted at planning and first-time parents.
“The community awareness study is useful to show exactly what knowledge gaps should be addressed in educational campaigns so we can ensure the RSV immunisation program has a bigger impact,” Associate Professor Moore said.
Next steps
- The team will undertake further studies examining RSV and immunisation awareness among different population sub-groups
- Education materials informed by community awareness studies will be developed to raise RSV awareness
- Associate Professor Moore’s team will use further mathematical modelling studies, like those used during COVID-19, to predict the impact of both a monoclonal antibody and maternal vaccine