Impfung gegen RSV-Infektionen – Update und Ausblick

Was ist neu?

Pathologie und Bedeutung der Grundlagenforschung 60 Jahre nach einer katastrophalen RSV-Impfstoffstudie mit Todesfällen bei Kindern erleben wir momentan eine rasant positive Entwicklung mit 3 zugelassenen Impfstoffen gegen RSV bei Personen >60 Jahre. Die Grundlagenforschung gegen RSV spielte auch eine entscheidende Rolle in der Impfstoff-Entwicklung gegen SARS-CoV-2.

Neue RSV-Impfstoffe Im Jahr 2023 erhielten innerhalb von wenigen Wochen gleich 2 äußerst ähnliche, proteinbasierte Impfstoffe die Zulassung der Europäischen Arzneimittelbehörde (EMA). Aktuell sind 3 aktive Impfstoffe gegen RSV zugelassen.

RSV-Impfung und Prävention bei Kindern Neben der aktiven Impfung von Schwangeren hat auch der von der STIKO empfohlene, lang wirksame monoklonale Antikörper Nirsevimab als einmalige passive Impfung von Säuglingen im 1. Lebensjahr das Potenzial, vor schwerer Erkrankung zu schützen, ohne den Aufbau einer natürlichen Immunität zu beeinträchtigen. Zahlreiche weitere RSV-Impfstoff-Kandidaten mit unterschiedlichem Grundgerüst und verschiedenen Herstellungsverfahren befinden sich in der klinischen Prüfung.

Abstract

Almost 60 years after a disastrous clinical vaccine trial in children, which resulted in enhanced disease and even deaths, the world of RSV vaccination is currently undergoing a dramatic positive change and development, closely linked to advances in new vaccine technologies. Three licensed safe and highly efficacious vaccines, Abrysvo, Arexvy and mRESVIA, reduce the incidence of RSV lower respiratory disease by 80% in people older than 60 years of age. Questions regarding long-term protection and effectiveness in specific risk groups with chronic medical conditions remain, and furthermore, innovative and safe concepts to actively vaccinate pregnant women and infants to prevent severe RSV infections – also in these high-risk populations – are eagerly awaited.

Passive vaccination with the long-acting monoclonal antibody Nirsevimab for prevention of severe disease in the first RSV season of infants is a major innovation in global health and the importance and benefits of reducing the number of intramuscular injections for high-risk children is immense. In the coming years, results of numerous pediatric candidate RSV vaccine studies are expected, although particular caution seems advisable for historical reasons. In summary, the field of RSV vaccination has been revolutionized in the last 2 years and we will see further significant progress soon.

Schlüsselwörter

Synzytialvirus - RSV - Impfstoff - monoklonale Antikörper - Prävention

Keywords

respiratory syncytial virus - RSV - vaccine - monoclonal antibodies - prevention

Publication History

Article published online:
22 October 2024

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