Optimal Strategy for RSV Protection in Infancy: Maternal Vaccine or Newborn Monoclonal Antibody?

Sunday, May 5, 2024

2:00 PM – 3:30 PM ET

Location: Metro Toronto Convention Centre: 206 BD

CE: Live CME: 1.5

Selected By: PIDS
Co-sponsored By: Neonatal

Chair(s)

Dustin Flannery, DO, MSCE

Assistant Professor of Pediatrics
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
KW

Kelly Wade, MD PhD MSCE (she/her/hers)

Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Philadelphia, Pennsylvania, United States

Disclosure(s):

Dustin D. Flannery, DO, MSCE: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Kelly Wade, MD PhD MSCE: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Session

Description: RSV is the leading cause of infant hospitalization and a leading cause of infant mortality. Seasonal monthly administration of monoclonal antibodies (palivizumab) decreases the risk of RSV-associated hospitalizations among high-risk infants but has multiple limitations. In July 2023, the U.S. FDA approved a single-dose monoclonal antibody (nirsevimab-alip) for infant protection. In August 2023, the U.S. FDA approved an RSV vaccine administered to pregnant women during the third trimester for infant protection. Within the last few months, strategies for infant RSV protection went from limited to abundant, but questions remain regarding the optimal prevention strategy for all infants. The maternal vaccine has safety concerns about increased preterm births that limit the administration window to 32-36 weeks and reduced pertussis antibody when co-administered with Tdap limits coadministration. Four vaccines are recommended during pregnancy –Tdap, COVID-19, influenza, and RSV. Only COVID-19 and influenza vaccination confer both maternal and newborn protection. Will pregnant patients accept this new RSV vaccine? Should both maternal vaccine and newborn monoclonal antibody be routinely administered, or just one? Should the monoclonal antibody be given in the hospital or in the outpatient pediatric setting, and who should pay for it?
This Hot Topic Symposia will discuss the past and present state of RSV disease in infancy, review the newly FDA-approved maternal vaccine and newborn monoclonal antibody, and begin to unpack the issues around optimal strategy for RSV protection in infancy. The content will be applicable to attendees who practice general pediatrics, neonatology, infectious diseases, immunology, pharmacy, and health policy.

Learning Objectives:

To review the past and present state of RSV disease in infancy
To review the newly FDA-approved maternal vaccine and newborn monoclonal antibody
To identify questions that remain regarding optimal strategies for RSV protection in infancy and provide evidence and policy-based updates to date

Presentations:

2:00 PM – 2:40 PM ET

1) Opening and Introductions [5min]; 2) RSV Disease in Infancy [15min]: Past and Present; 3) Discussion and questions [20min]
Speaker: Dustin D. Flannery, DO, MSCE – Children's Hospital of Philadelphia
2:40 PM – 2:55 PM ET

Maternal Vaccination for Infant Protection from RSV
Speaker: Buddy Creech, MD, MPH – Vanderbilt University School of Medicine
2:55 PM – 3:15 PM ET

1) Monoclonal Antibody for Infant Protection from RSV; 2) Closing Remarks
Speaker: Kelly Wade, MD PhD MSCE (she/her/hers) – Perelman School of Medicine at the University of Pennsylvania
3:15 PM – 3:30 PM ET

RSV Prevention in 2023-2024: More Questions than Answers?
Speaker: Karen M. Puopolo, MD, PhD (she/her/hers) – Perelman School of Medicine at the University of Pennsylvania