Dr Michael Petrosky Discusses Vaccines, Monoclonal Antibodies in RSV

Michael Petrosky, MD, of Allegheny Health Network, spoke about the difference between vaccines and monoclonal antibodies and how they can affect treatment in respiratory syncytial virus (RSV).

Michael Petrosky, MD, of Allegheny Health Network, spoke about how new monoclonal antibodies can benefit treatment of respiratory syncytial virus (RSV).


What are the differences between vaccines and monoclonal antibodies in RSV?

When you talk about any immunization type stuff, there's 2 main types. There's what we call active and passive immunization. The active is what we've known for the longest. I mean, that's a lot of the typical vaccine schedule. For some vaccines, there's oral vaccines [which] are the ones you have to give an injection, where you either inject parts of a virus or bacteria or a weakened virus or bacteria. And then your body sort of responds to that. So your own immune system identifies those materials as foreign, they create antibodies against those, and they also create what we call memory cells so that later on in life, if the same material gets introduced, your body's already aware of it, and it can start producing your own antibodies. So that's what we call more the active immunization, and that's a lot of the other vaccines we've had go through before.

The monoclonal antibodies, that's more of what we call passive immunization, so that's where the antibodies are already made. In the case with RSV, those are antibodies made in a lab and you get those injected into your own body, so the antibodies are already there. So they know how to attach to, in this case, the RSV. Over time your body degrades them because they're not your own, so that's where they don't last as long. So the active immunization usually works better, gives you more lifelong protection, whereas the passive immunization it gives you good protection for that certain amount of time until your body sort of starts degrading what they consider foreign.

How helpful are monoclonal antibodies in treatment of RSV?

It's definitely helpful. The big thing about this new one that's coming out for RSV in infants is just how long it lasts. So for years, we've actually had monoclonal antibodies against RSV as a different product. It didn't last as long, so kids actually had to come in for the injections like once a month for 5 to 6 months, every RSV season. When they looked at how much it cost and how effective it was, only a small percentage of kids were actually eligible for those, for the older ones. Those are kids born really premature or had specific heart, lung, or even immunodeficiency issues. So having a 1-dose [vaccine that] can last the whole RSV season, and protect anyone who's technically under 8 months eligible for the first season, is definitely helpful so we can get more protection out there.

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