RSV Burden in Nigeria, upcoming RSV vaccines and support by Partners
Respiratory Syncytial Virus (RSV) is a significant burden in Nigeria and Africa, particularly among infants and young children. RSV is a common cause of acute lower respiratory tract infections, such as bronchiolitis and pneumonia, which can be severe and life-threatening.
According to the World Health Organization (WHO), RSV is estimated to be responsible for approximately 3.2 million hospital admissions and 118,200 deaths annually among children under five years of age worldwide. In addition, RSV is estimated to cause 3–7% of deaths in older adults during the winter months. A study published in The Lancet Global Health revealed that RSV accounted for 22% of acute lower respiratory infections in children under five years of age in sub-Saharan Africa in 2015, resulting in over 118,000 deaths. The burden of RSV is particularly high in countries with a high prevalence of risk factors, such as premature birth, low birth weight, and malnutrition.
In Nigeria specifically, RSV is a major cause of morbidity and mortality in young children. According to a study published in PLoS One, RSV was responsible for 40% of hospitalizations for acute lower respiratory tract infections in children under five years of age in Nigeria. The burden of RSV in Nigeria and even in Africa is likely underestimated due to the lack of widespread testing and surveillance for the virus. However, it is clear that RSV is a significant burden on the healthcare system and a major contributor to childhood morbidity and mortality in Nigeria and other countries in Africa.
Currently, there are no licensed vaccines available for RSV, but there are ongoing efforts to develop effective and safe vaccines. There are two main types of RSV vaccines under development: live attenuated and subunit vaccines.
Live attenuated RSV vaccines are made by weakening the virus so that it cannot cause severe disease but can still trigger an immune response. These vaccines are administered intranasally and aim to stimulate immunity at the site of infection, the respiratory tract. Live attenuated vaccines have shown promising results in animal studies and clinical trials, but more research is needed to determine their safety and effectiveness.
Subunit RSV vaccines are made by using proteins from the virus, either in a purified form or as virus-like particles. These vaccines are administered via injection and aim to stimulate a systemic immune response. Subunit vaccines have shown good safety profiles in clinical trials, but they may require multiple doses to achieve optimal protection.
In addition to these types of vaccines, there is ongoing research into other vaccine strategies, such as DNA vaccines and viral vector vaccines. Developing an effective RSV vaccine is challenging due to the complexity of the virus and the unique immune response it elicits. However, the potential benefits of an RSV vaccine, particularly for vulnerable populations such as young children and elderly adults, make the ongoing research efforts crucial.
Development partners such as the Bill and Melinda Gates Foundation (BMGF) and Gavi, the Vaccine Alliance, are actively supporting the development and delivery of RSV vaccines for children and maternal vaccination to protect infants against RSV. In 2015, the Bill and Melinda Gates Foundation announced a $138 million grant to support the development of RSV vaccines for maternal immunization and for young children. The grant was awarded to the Coalition for Epidemic Preparedness Innovations (CEPI), a public-private partnership that funds and coordinates vaccine development against emerging infectious diseases, including RSV.
Gavi, which provides access to vaccines for children in low-income countries, has also been supportive of RSV vaccine development. In 2020, Gavi launched a new funding mechanism, the Advanced Market Commitment for RSV Vaccines (AMC-RSV), to help accelerate the development and delivery of affordable RSV vaccines for use in low- and middle-income countries. Through this mechanism, Gavi aims to secure a supply of RSV vaccines for eligible countries at an affordable price, while also incentivizing vaccine manufacturers to develop and produce RSV vaccines for these markets. The support from the BMGF and Gavi is crucial in advancing RSV vaccine development and delivery, particularly for vulnerable populations in low- and middle-income countries where the burden of RSV is highest.
Efforts to prevent RSV, such as developing and deploying effective vaccines, have the potential to save lives that would have otherwise been lost to pneumonia and other respiratory diseases. RSV is a significant cause of acute lower respiratory infections (ALRI), including bronchiolitis and pneumonia, particularly in young children and older adults.
Preventing RSV infections can, therefore, help reduce the incidence and severity of ALRI and related complications, such as respiratory failure, which can be life-threatening. By reducing the incidence and severity of RSV, efforts to prevent RSV can also help reduce the burden on healthcare systems, particularly in low- and middle-income countries where resources may be limited. RSV can weaken the immune system increasing the incidence and severity of other respiratory infections such as bacterial pneumonia.
Overall, preventing RSV infections can have a significant impact on reducing the burden of respiratory diseases and saving lives that would have otherwise been lost to pneumonia and other respiratory diseases. Because vaccines work and have proven to be effective in disease prevention, let us join partners supporting the development and introduction of the RSV vaccine to save lives.
