Leicester-led study supports potential new infant immunisation programme

Professor Damian Roland

Findings from a Leicester-led study into the rates of children coming to A&E with respiratory infections have supported a recommendation to the UK Government to introduce a new immunisation programme against Respiratory Syncytial Virus (RSV) for all children under two. 

The study, called BronchStart, collected data on all children under the age of two with symptoms of an acute lower respiratory tract infection who visited participating children’s A&E departments between May 2021 and April 2022. In all 17,914 attendances were recorded. 

RSV was identified as the cause of the respiratory infection in 48.7% of children aged 0-11 months, and 27.4% in children aged 12 to 23 months.  

RSV is a common respiratory virus that usually causes mild, cold-like symptoms. However, for some people, especially those who are under two – and in older people over the age of 75 – there is a greater risk of the infection developing, leading to breathing difficulties and hospitalisation. It is a leading cause of infant mortality globally, resulting in 20 to 30 deaths per year in the UK. 

RSV accounts for approximately 33,500 hospitalisations annually in children aged under five years old. 

The Joint Committee on Vaccination and Immunisation (JCVI) reviewed the evidence from the data gathered from BronchStart, as well as a second study called Stop RSV, to make estimates on national hospitalisation rates, as well as get a better understanding of the treatments given, such as fluids, antibiotics, and oxygen. 

Professor Damian Roland, a consultant in children’s emergency medicine at the University Hospitals of Leicester NHS Trust, led the BronchStart study. 

He said: “Introducing a new immunisation programme must be both cost-effective and have a positive impact on public health. 

“Studies like the BronchStart provide the data needed to help policymakers take informed decisions. We have shown the rates of RSV in children under two and the types of treatment they received over a year. This means the committee could calculate the costs to the NHS and balance that against the costs of implementing an immunisation programme. 

“We’re delighted that our network of researchers in children’s emergency medicine across the UK and Ireland could make such an important contribution, and hopefully save young lives.” 

The JCVI also reviewed the results of clinical trials of potential preventative measures for RSV, including the HARMONIE study, which recruited 32 infants in the National Institute for Health and Care Research (NIHR) Patient Recruitment Centre: Leicester. 

Gathering this information helps the Government decide which vaccines or other preventative measures it may choose to use as part of any immunisation programme, based on how effective it is at preventing disease, how long immunity lasts, and the cost-effectiveness of each option. 

BronchStart was funded by PERUKI (Paediatric Emergency Research United Kingdom and Ireland) and RESCEU (REspiratory Syncytial virus Consortium in EUrope). 

The full JCVI statement is available at GOV.UK