Parental knowledge about respiratory syncytial virus (RSV) and attitudes to infant immunization with monoclonal antibodies

Figures & data

Figure 1. Self-reported knowledge about respiratory syncytial virus (RSV) and bronchiolitis.

Information 1. Information presented to respondents about respiratory syncytial virus (RSV).

Respiratory syncytial virus (RSV) is a common seasonal virus that infects nearly all children (90%) within their first two years of life. RSV is contagious and is transmitted through oral or nasal secretions. In infants 12 months and younger, mild, cold-like symptoms may include congestion, cough and decrease in appetite. However, many will develop a lower respiratory tract infection (bronchiolitis or pneumonia), and in rare cases, medical intervention is needed to regulate breathing. RSV is the most common cause of hospitalization for lower respiratory tract infection (LRTI) in young children. It is difficult to predict which babies will become severely ill, and most babies who are hospitalized due to RSV are otherwise healthy and were born full-term. Options for Prevention and Treatment • Currently, only very premature babies or babies born with conditions such as chronic lung disease or congenital heart disease receive immunization against RSV. This requires monthly injections throughout the typical five-month RSV season. There is no immunization against RSV for healthy babies. • The risk of RSV illness may be reduced – but not eliminated – by washing an infant’s toys, clothes, and bedding often, as well as washing hands before touching an infant. • There is no actual cure for RSV disease; treatment consists of symptom relief and supportive care. • Natural infection does not provide immunity, so it is possible to have more than one RSV infection in the same season. At a Global Level Globally, roughly one in every 160 children younger than five years who develop acute lower respiratory infections (LRTI) caused by RSV will die. The majority of deaths occur in developing countries

Table 1. Parental perceptions of the risk and severity of RSV infection before and after receiving RSV information.

	Perceived Risk of Contracting RSV						Perceived Severity of RSV
	Low		Moderate		High		Mild		Moderate		High
	Before info	After info	Before info	After info	Before info	After info	Before info	After info	Before info	After info	Before info	After info
Assessment•
USA %	19	13	53	55	28	32	8	9	48	56	44	35
Europe %	19	12	60	65	21	23	4	7	49	66	47	28
Japan %	11	3	66	72	23	25	9	7	68	73	24	20
China %	7	3	48	44	45	53	2	1	38	32	60	67
Total %	16	10	58	62	26	28	5	7	49	61	46	33

*Assessments of risk and severity of RSV refer to responses to a 1–7 scale: Low risk/mild severity = responses 1–2. Moderate risk/severity = 3–5. Very high risk/very severe = 6–7. It should be noted that only parents who had stated to be aware of RSV were asked about their perceptions of risk and severity of RSV prior to receiving the RSV information. All respondents were asked about their perceptions of the risk and severity of RSV following the information.

Information 2. Information presented to respondents about a new immunization against RSV.

Product X Product X is the first immunization to prevent RSV disease in all infants. It provides protection for the entire RSV season (from autumn to spring) with one injection in a muscle. In a recent global clinical trial, one dose of Product X, given before the RSV season, offered healthy preterm infants protection against RSV disease throughout the RSV season. 70% of these infants were protected from lower respiratory tract infection (LRTI) due to RSV; and 78% were protected from risk of hospitalization with RSV-related LRTI. Clinical trials have proven Product X to be very safe with few adverse reactions, comparable to placebos. Product X has received the following designations from regulatory agencies: • Shown in the US: US Food and Drug Administration: Breakthrough Therapy • Shown in France, Germany, Italy, and Spain: European Medicines Agency: ‘PRIME’ designation • Shown in the UK: UK Medicines and Healthcare Regulatory Agency: Promising Innovative Medicine’ designation • Shown in China: China Center for Drug Evaluation: Breakthrough Therapy • Shown in Japan: Japan Agency for Medical Research and Development (AMED): ‘A product of high priority’

Figure 2. Parental acceptance of infant immunization against RSV.

Question: ‘If Product X were recommended as part of the immunization programme and by your infant child’s healthcare professional, how likely would you be to accept this RSV immunization for your infant child?’ Responses on a scale of 0–10 where 0 = ‘No chance/almost no chance’ and 10 = ‘Certain/practically certain’ to accept: red (0–2) = low chance; yellow (3–7) = some chance; green (8–10) = high chance.

Information 3. Information given about passive immunization and monoclonal antibodies (mAbs).

Please read the information below, which explains how Product X works vs. some other immunizations. There are two types of immunization: active and passive. Current childhood immunizations are defined as ‘active immunizations.’ Active immunization works by activating the immune system to produce antibodies, which protect the body from a specific infectious disease. It can take days to weeks to develop this protection. ‘Passive Immunization’ with monoclonal antibodies (mAbs) works by transferring antibodies directly into the patient via injection in a muscle. This is defined as a biological product offering rapid protection from a specific infectious disease.