A Lancet Infectious Diseases review summarises the RSV prevention landscape: a maternal vaccine, long-acting infant monoclonal antibodies, and vaccines for older adults and high-risk younger adults are approved, with 39 more candidates in development.
Real-world data confirm high effectiveness, and in older adults there are emerging signals of benefit beyond the lungs, including fewer cardiovascular events. Maternal vaccination and infant monoclonal antibodies perform comparably, yet uptake differs widely between countries and products.
The authors' central point is that availability alone does not deliver protection: uptake depends on integration into routine care and on a recommendation from a trusted clinician. Cost currently limits these products mostly to higher-income settings. In India, availability and price of each product vary, and national programme recommendations for RSV immunisation are not yet in place.
- Recommend RSV immunisation where it is available — a clinician's advice is the strongest driver of uptake
- For infants, maternal vaccination and an infant monoclonal antibody give comparable protection
- Consider RSV vaccination for older adults and high-risk younger adults where accessible
- Check local availability and cost before advising a specific product
Why it matters
The gap in RSV protection is now one of delivery, not of evidence.
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