Uniting research and maternal vaccination against respiratory syncytial virusUniting research and maternal vaccination against respiratory syncytial virus

Dubai, like all global cities, might face potential health challenges including. Respiratory Syncytial Virus (RSV) which might significantly affect infants. The Dubai Health Authority (DHA) oversees healthcare standards in the emirate emphasising the importance of addressing RSV and exploring maternal vaccination to advance the healthcare ecosystem.

RSV is a common respiratory virus that can cause severe infections, especially in infants and young children. The virus often leads to trouble breathing, hospitalisations, and in severe cases, even fatalities among vulnerable populations. In Dubai, RSV is responsible for nearly one-sixth of paediatric healthcare encounters, with an average hospital stay of about four days.

Beyond the individual suffering, RSV outbreaks strain healthcare resources, burden families emotionally and financially and can disrupt societal functioning. By prioritising RSV prevention and management, Dubai not only safeguards the health and well-being of its youngest citizens but also strengthens its healthcare system’s resilience.

One promising avenue in the fight against RSV is maternal vaccination. By vaccinating expectant mothers, antibodies are transferred to their newborns, providing passive immunity during the critical early months of life when infants are most vulnerable to RSV infections. This proactive approach not only shields infants from severe RSV-related complications but also reduces the burden on healthcare facilities by lowering hospitalisation rates and associated costs.

However, awareness about RSV and maternal vaccination remains low in Dubai. To address this, comprehensive educational campaigns targeting healthcare providers, expectant mothers, and the wider community are needed to dispel myths and foster informed decision-making. Despite Dubai's advanced healthcare infrastructure, enhancing infrastructure and integrating vaccination into routine prenatal care remain logistical challenges.

To effectively combat RSV, understanding Dubai's local burden is essential. A study in collaboration with Pfizer Dubai, Pfizer Biopharmaceuticals, the Gulf region, and the DHA, analysed insurance claims data from Jan 2014 to September 2023, to assess RSV's impact on children. This study involved patients under 18 with a first-episode diagnosis of RSV and tracked outcomes over three months.

The study covered 28,011 patients, identifying 25,729 child cases (92 per cent) with RSV, 42 per cent of whom had an RSV-associated respiratory diagnosis. Notably, in the zero to two-year age group, risk factors like congenital and immunodeficiency disorders were present in one per cent. The average hospital stay was around four days. Substantial hospitalisation costs were noted across all age groups, emphasising the need for enhanced RSV research and development to improve treatments and vaccines. These findings could guide future healthcare policies.

Another study in affiliation with organisations including Pfizer Gulf and the DHA estimated the five-year financial impact of novel vaccine RSVpreF among pregnant women compared with no intervention for the protection of privately insured infants aged under one year in Dubai.

Both the clinical effects and financial implications of RSV lower respiratory tract infections were evaluated among infants using deterministic cohort model to depict clinical outcomes and economic costs of RSV-LRTI and maternal vaccination for infants from birth to one year of age (with an assumed uptake rate of 10 per cent).

The outcomes projected by the model included cases of RSV-LRTI (respiratory syncytial virus lower respiratory tract infections), deaths attributable to RSV-LRTI and costs associated with RSV-LRTI and vaccination. These were forecasted for the first year of life across five yearly birth groups.

The results showed that over five years without the use of maternal RSVpreF there would be nearly 2,000 respiratory syncytial virus lower respiratory tract infections hospitalisations, 5,655 respiratory syncytial virus lower respiratory tract infections cases requiring emergency department care and 15,652 respiratory syncytial virus lower respiratory tract infections cases requiring outpatient clinic (OC) care – with the corresponding total medical care costs being US$11.5 million.

Year-round use of RSVpreF among pregnant women would prevent 107 hospitalisations, 196 cases requiring ED care and 549 cases requiring OC care over five years. With medical care costs projected to be lower by US$0.5 million and the cost of vaccination projected to be US$3.6 million, resulting in a budget impact of US$0.19 per member per year.

Findings from this analysis show that the use of RSVpreF among pregnant women in Dubai would considerably reduce cases of respiratory syncytial virus lower respiratory tract infections as well as reduce the economic burden among privately insured infants with minor added cost per covered life.

With the studies showing that RSVpreF among pregnant women in Dubai would considerably lower cases of respiratory syncytial virus lower respiratory tract infections among privately insured infants with minor added cost per covered life and that there are significant hospitalisation costs for children suffering from RSV, the need for sustained research efforts and decisive action against RSV cannot be overstated.

By prioritising ongoing research initiatives and implementing proactive measures, such as maternal vaccination, we can significantly enhance public health outcomes and reduce the burden of RSV. Maternal vaccination not only safeguards mothers but also gives protective antibodies to infants, offering a critical defense against RSV during their most vulnerable stages of development.

Policymakers, healthcare professionals and communities need to champion maternal vaccination programs and support ongoing research efforts. Together, we can protect mothers and infants, ensuring healthier futures for generations to come. 

Dr. Mohamed Farghaly is the Professor of Medicine, Dubai Medical College, Consultant Family Medicine and Diabetes Management, Scientific Chairman, Emirates Family Medicine Society.