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Bronchiolitis: what are the treatments and vaccines for this disease?

This is a disease of unprecedented proportions for several years, which is currently affecting France and other European countries. Our bronchiolitis epidemic has intensified further in recent days, with hospitalizations higher than in the previous three seasons and equivalent to a pre-Covid peak, health authorities noted on Thursday, November 3rd.

There is currently no vaccine for this common and highly contagious respiratory disease in infants. But treatments are being developed. The European Union (EU) has approved the prophylactic treatment for bronchiolitis nirsevimab, announced on Friday by the AstraZeneca and Sanofi groups developing the drug. The European Commission has approved this treatment “for the prevention of respiratory syncytial virus (RSV) infections in infants,” French group Sanofi said in a press release. RSV is one of the viruses that causes bronchiolitis, a disease that mainly affects children and which, although usually mild, causes symptoms that are often dramatic and sometimes require hospitalization.

Nirsevimab, sold under the name Beyfortus, is not strictly speaking a vaccine, but acts with the same preventive purpose: it is given in a single injection and is aimed at preventing the onset of bronchiolitis. This is a treatment with synthetic antibodies that directly provides the body with a weapon to fight the disease and allows you to give the child the so-called passive immunity. Instead, a vaccine allows the body to make these antibodies on its own.

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The approval of this treatment, which received a positive opinion last September from the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency, marks a major milestone in the fight against bronchiolitis. However, it will not spread fast enough to affect the epidemic this season. “Beyfortus will be available next season – 2023 – for bronchiolitis,” Sanofi told AFP.

“RSV prevention is within reach”

It is the first drug to prevent severe bronchiolitis in all children. Another prophylactic drug, also produced by the Swedish-British group AstraZeneca, already exists, but is only indicated for children at risk or premature babies. Other treatments of this type should be followed.

About 30 vaccines or monoclonal antibodies are currently in clinical trials, according to a summary published this summer by the Lancet Infectious Diseases. British GSK and American Moderna and Johnson & Johnson, in particular, are working on vaccines against RSV. “Prevention of RSV is within reach,” summed up the authors of a document published by Lancet Infectious Diseases, recalling that this virus is the second cause of childhood death in the world, mainly in poor or middle-income countries.

The US group Pfizer announced on Tuesday positive results from clinical trials of a vaccine against RSV, which causes bronchiolitis, in newborns and infants, given to mothers during pregnancy. According to the results of this phase 3 trial published by the company, the vaccine was about 82% more effective in preventing serious cases in the first three months of a child’s life and about 69% over the next six months.

The trial, however, did not conclude that the vaccine “statistically significantly” reduced the number of non-severe cases, even if the tests showed some clinical benefit, the lab said. Based on these results, which have not been reviewed by independent scientists, Pfizer plans to have the vaccine approved for pregnant women by the end of the year in the US and other countries thereafter.

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