Advocacy for neonates: Will respiratory syncytial virus monoclonal antibodies and maternal vaccine be made available in India?

Respiratory syncytial virus (RSV)-related morbidity in children has been widely described. Research has led to the availability of palivizumab for decades in high-income countries. Ongoing research underlines the high priority given to this conundrum. Nirsevimab, a long-acting monoclonal antibody, and a maternal vaccine have been developed and approved for RSV. Neither of these are available in India. Improving the survival of extreme preterm neonates in our country should parallel other strategies to protect them from diseases that affect these high-risk neonates. This case series comprises sick RSV-infected infants from our centre over a single season. Of 187 young infants who presented to the Neonatology Department with features of viral lower respiratory infections, 9 (4.8%) required intensive care. All of them were positive for RSV by nasopharyngeal polymerase chain reaction. A total of 25 (13%) required hospitalisation. Preterm infants presented with apnea or severe respiratory distress. All 9 in the intensive care unit required respiratory support, and 8 needed invasive ventilation. The median duration of hospital stay for these infants was 18 (7–37) days. This report is an appeal to stakeholders towards making these evidence-based prophylactic methods available in India. A preventable problem in high-risk neonates could be reduced. Improving neonatal survival and outcomes calls for our country to be at par with high-income countries for RSV prevention. RSV-related morbidity is an endemic conundrum with a high disease burden. We could take prompt action, akin to efforts taken during the COVID-19 pandemic.