ABSTRACT
In this issue of Pediatrics, Rostad et al1 summarize the interim analysis of the safety and immunologic results of 4 approaches to achieve levels of anti-RSV (respiratory syncytial virus) neutralizing antibodies (nAbs) to protect very young infants against severe RSV lower respiratory tract disease, beginning with maternal immunization with an antigen-based RSV prefusion F vaccine (RSVPreF) (Group 1A) or sequential combination of both interventions—maternal immunization with an RSVPreF vaccine followed by passive immunization of infants with anti-RSV nAbs (nirsevimab), either at birth (Group 1B) or at 3 months of age (Group 1C), or passive immunization with anti-RSV nAbs alone at birth (Group 2). To put these approaches in perspective, physicians should recall that attempts to reduce the impact of RSV on young infants have been a multigenerational challenge. Use of a simple formalin-inactivated RSV vaccine in the 1960s led to worsened clinical outcomes during subsequent natural infection.2 Continuing…