Why RSV prevention for infants is still years away in India
Respiratory Syncytial Virus (RSV), a common but potentially serious infection among infants, is emerging as a growing concern in India, especially during the post-monsoon and winter seasons.While global health agencies such as the World Health Organisation (WHO) have begun recommending maternal RSV vaccination to protect newborns, India is still in the early stages of evaluating and adopting preventive strategies."RSV is one of the leading causes of lower respiratory tract infections in infants and young children globally, and in India too. Studies from Indian tertiary centres show that RSV accounts for 30–50% of bronchiolitis and pneumonia cases in children under two. The highest risk is among infants below six months, those born prematurely or with underlying conditions," said Dr. Shreya Dubey, consultant, neonatology and paediatrics, CK Birla Hospital, Gurugram.advertisement
Dr. Rahul Sharma, additional director, pulmonology, Fortis Hospital, Noida, echoed this. "An estimated 2–3 million pneumonia cases in India annually are linked to RSV, with many requiring hospitalisation, especially among children under five," he said.The WHO's recent endorsement of RSV vaccination during pregnancy aims to protect newborns through passive immunity.However, India is still reviewing its inclusion in the Universal Immunisation Programme (UIP). "Bodies like the Indian Academy of Pediatrics are assessing the vaccine's safety, efficacy, and cost-effectiveness for Indian settings. If introduced, it may first be rolled out to high-risk groups in private or corporate hospitals,' Dr. Dubey said.Monoclonal antibodies such as Nirsevimab, which can prevent severe RSV infection with a single dose, have shown promising results. But cost is a major concern. 'Currently, one dose of monoclonal antibody treatment could cost between Rs 50,000 to Rs 1,00,000. Without government subsidies or insurance coverage, it will remain out of reach for many Indian families," said Dr. Sharma.advertisementDr. Dubey stressed the need for differential pricing and public health integration. 'Government partnerships, local manufacturing, and inclusion under public health schemes will be crucial for equitable access," she said.Indian pharmaceutical giants like Bharat Biotech and the Serum Institute of India have already initiated RSV vaccine research. Collaborations with global pharma companies could also help manufacture monoclonal antibodies locally, significantly lowering costs."India has a strong vaccine manufacturing ecosystem. This positions us to become a regional hub for RSV prevention," Dr. Dubey explained.However, the timeline for availability remains uncertain. The doctors estimate it may take another 2 to 4 years for widespread access, depending on regulatory clearances and production scale."Maternal vaccines could come earlier in select hospitals. Monoclonal antibody therapies might begin with pilot programs for high-risk groups in the next year or two," added Dr. Dubey.RSV prevention in India is clearly gaining momentum, with strong clinical evidence and global precedents.'The groundwork is there,' said Dr. Sharma. 'Now it's about making sure the solution is accessible, not just available.'
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