A vaccine against the RS virus for pregnant women could prevent hundreds of babies from ending up in hospital in a very sick way every year. In the coming months, the Health Council will consider how best to use the vaccine that has just been approved. Four questions for pediatrician-infectiologist Louis Bont of UMC Utrecht.
How bad is that rs virus really?
Babies and the elderly in particular can become very ill from the virus. Every year, about three thousand children end up in hospital, about two hundred have to go to intensive care. “This virus causes a lot of mucus,” explains Louis Bont. Babies younger than six months in particular cannot cough up that mucus properly. They don’t have enough power for that. And because those airways are so narrow, a little mucus is enough to clog things up.”
The result is that the little ones get very stuffy and sometimes have to be put on a ventilator in the hospital. “With the children in the ICU, the breathing machine takes over, so that the babies can sleep and do not need anything else. In countries without IC, these children die. It is the second leading cause of death among infants in the world,” said Bont. In the Netherlands, children die ‘sporadically’ from the RS virus.
The European medicines agency EMA approved a second vaccine before the weekend. What can be expected?
The vaccine that has now been approved is intended for use in pregnant women. The vaccine gives them an immune response against the rs virus. They pass on this defense to the unborn child via the umbilical cord. “As a result, babies also have good protection during the first six months,” says Bont, who also participated in the research into the vaccine.
Research shows that the effectiveness is 70 percent. Women should receive the vaccine from 24 weeks of pregnancy. Bont: “We hope to be able to prevent half of the number of hospital admissions.”
Are pregnant women willing to get vaccinated?
That is the question. And that is why it is not entirely possible to predict how fast the number of hospital admissions is falling.
Nevertheless, pediatrician Bont is optimistic. “Pregnant women can already get vaccinated against whooping cough. The turnout at those vaccination rounds is quite large, while no one has seen such a sick baby. Rs often know people from their environment, so that could have a positive influence on the willingness of pregnant women to get vaccinated.” But no, the doctor does not expect a 100 percent vaccination rate.
If the mothers do not want to be vaccinated, there is a second option: to vaccinate the babies. A second vaccine was approved in October. “It’s about as effective.” Bont sketches the scenario that babies born in winter get that jab in the first days of their early life. Especially babies who are six months or younger can become very ill. Babies born in the summer can wait until the fall.
Incidentally, this vaccine can also be a solution for premature babies. The pregnancy vaccine does not work well enough for these children, because there is insufficient time to get the antibodies to the baby via the umbilical cord.
What now?
The vaccines do not yet offer a solution for next winter. The Health Council is now looking at how best to use the two vaccines. When should pregnant women get the shot? When is it better to use the baby vaccine? That advice should be available early next year. It is expected that the first injections can then be made before the winter of 2024/2025.
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