Opinion | It’s time to advocate for an RSV vaccine for children
However, the lack of even a Phase III pediatric vaccine trial for RSV, which comes in the middle of a a bout of illnessit feels like a missed opportunity, born of the tendency not only of medical researchers, but of society as a whole, to put young children last.
For those not caring for young children or elderly parents, RSV may sound as foreign as covid-19 did in January 2020. This is true even though most people had RSVseeing it as a mild cold that probably never required a medical diagnosis.
But for children younger than 5 and adults 65 and older, the virus is a formidable antagonist that can cause serious lung infections. According to the Centers for Disease Control and Prevention, RSV leads to 58,000 hospitalizations in children younger than 5 years and 177,000 hospitalizations in adults 65 and older each year, and annually kills between 100 and 300 young children and 14,000 elderly people. Compare that to 369 infants and 196 children between the ages of 1 and 4 who have died covid-19 throughout the course of the pandemic. The CDC notes that even 2 percent infants younger than 6 months who get RSV may need to be hospitalized.
RSV infections do not only harm the children who become infected. This fall, an increase in RSV cases full of children’s hospitals from Connecticut to DC to Texas — meaning that both children with RSV and those who need care for other serious health problems could end up receiving treatment at home or face transfers to distant hospital care facilities.
This situation, which occurs when covid-19 goes from a pandemic to endemicis horrible for children and crazy for the adults trying to treat and care for them.
During the worst of the pandemic, young children lived in confined worlds to protect everyone else. They were the last to get access to coronavirus vaccines, which meant they were the last Americans still required to wear masks. The vaccines they received were based on earlier virus strainsrather than on the omicron variations that now prevail.
Given the sacrifices of young children on behalf of their communities, it seemed a reasonable reward for the medical establishment to increase its focus on the treatment and prevention of diseases that works disproportionately affect them.
Instead, RSV occasionally makes a nasty comeback when hospitals eliminate beds for children because they can make more money treating adult patients. Besides, promising results from phase III clinical trials for RSV vaccine candidates have it all elderly people includedand not pediatric items.
Of course, older Americans deserve protection from disease just as much as children, and it’s traditional to test drugs on adults first. And based on the results of a trial for older adults, there’s a reason to hope the early stage trials of pediatric RSV vaccinesas well as for immunizations that might be gives to pregnant womenfor the protection of the youngest babies.
Still, it’s harrowing to watch the number of pediatric hospitalizations for RSV rise and to think what would have been possible if only vaccines for children had progressed.
RSV trials for children and adults were postponed due to the pandemic when measures to contain the spread of Covid-19 led to an unusually mild flu and RSV season. (When no one is exposed to the disease the vaccine is trying to prevent, the people conducting the trials can’t compare placebo and vaccine groups to see if the vaccine works.) for the second year in a rowthe conditions would be ideal for large trials of pediatric vaccines.
If the trials were ongoing, parents of young children would at least know that there is some promise from this terrifying season. Instead, the best we can hope for over the holidays is that RSV spares our children.
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