Respiratory syncytial virus. What's new in prevention?

: Prevention of RSV lower respiratory tract infections (LRTI) in infants has been limited to general measures and palivizumab, a monoclonal antibody indicated for the highest risk groups. Recently developed RSV vaccines used during pregnancy generate antibodies that cross the placenta. Randomized controlled trials (RCT) and real-life monitoring have demonstrated their effectiveness in protecting newborns and infants during the first months of life. Likewise, novel extended half-life monoclonal antibodies, nirsevimab and the recently approved clesrovimab, opened the possibility of large-scale protection targeted to all infants born during the winter season and those <6 months at the beginning of it. Several RCTs and results from populations adopting nirsevimab prophylaxis demonstrated a large decrease in the incidence of RSV-LRTIs and a great impact in infant public health. Deployment of either strategies or in combination as part of immunization programs can be complement each other even as newer immunologic agents are being introduced.