Impact of respiratory syncytial virus on older children: Exploring the potential for preventive strategies beyond the age of 2 years

Vaccine. 2024 Aug 30;42(21):126170. doi: 10.1016/j.vaccine.2024.126170. Epub 2024 Jul 29.

Abstract

Objective: Respiratory syncytial virus (RSV) causes significant lower respiratory tract infections (LRTIs) in infants and young children. Current prevention targets those under 2 years. This study aims to evaluate RSV patterns and severity in children older than 2 years and to explore the potential extension of preventive strategies to this demographic group.

Methods: An observational retrospective study at Meyer Children's Hospital (from October 2019 to March 2023) analyzed data from patients between 28 days and 18 years of age with RSV infection. Severity indicators and patient characteristics were compared between two age groups: under 2 years and 2 years and above.

Results: 584 infants and young children were hospitalized due to RSV infection. Epidemic seasons saw a rise in hospitalizations among children older than 2 years. Older children had higher comorbidity (41% versus 9% p=0.000) and prematurity (26% versus 14% p = 0.001) rates than those under 2 years.

Conclusion: The study highlights the increased risk of severe RSV LRTIs in children older than 2 years and with prematurity or comorbidities, overlooked by current preventive measures. Prospective studies and cost-effectiveness analyses are needed to determine the necessity of targeted immunization for older children with specific risk factors, aiming to reduce RSV-related morbidity and mortality.

Keywords: Children; Hospitalization; Immunization; Prevention; RSV.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Comorbidity
  • Female
  • Hospitalization* / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Respiratory Syncytial Virus Infections* / epidemiology
  • Respiratory Syncytial Virus Infections* / prevention & control
  • Respiratory Syncytial Virus, Human* / immunology
  • Respiratory Tract Infections / epidemiology
  • Respiratory Tract Infections / prevention & control
  • Respiratory Tract Infections / virology
  • Retrospective Studies
  • Risk Factors
  • Seasons