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Introduction

Following a headline campaign from RCPCH, all four nations of the UK have announced a rollout of the RSV vaccine.

It has been confirmed that nations across the UK will see the roll out of two new RSV vaccination programmes for older adults and during pregnancy for infant protection from 12 August 2024 in Scotland and from September 2024 in England, Wales and Northern Ireland. 

This follows advice from the in June 2023 to the UK Government to begin vaccinating against RSV. In March 2024 over 2,000 healthcare professionals signed our open letter urging governments across the UK to implement an immunisation programme in time for winter 2024/25. 

We will now engage relevant stakeholders on the details of the announcement. We have developed this webpage for members to outline more information about the campaign, answers to questions and next steps for RCPCH. 

How your voice helped

In March 2024, over 2,000 paediatricians and healthcare professionals from around the UK signed an open letter calling on the UK Government to act on the JCVI advice as soon as possible. This showcased the strength of feeling among the profession. We sent this to the Chancellor of the Exchequer and Secretary of State for Health and Social Care on 18 March.

This letter called for:

• the UK Government to implement a full respiratory syncytial virus (RSV) immunisation programme for both infants and adults
• ensure funding is available for the governments of Scotland, Wales and Northern Ireland to introduce full immunisation programmes.

Media coverage

Our letter generated media coverage with headlines in the , the and over 200 local publications. 

UK parliamentary attention

MPs and Peers supported our calls for an RSV vaccination programme in the Commons and Lords. Daisy Cooper MP, Liberal Democrat’s health spokesperson, . Meanwhile, when a vaccination programme will be confirmed, with several Lords supporting the intervention.

Initial response

The UK Government responded to our open letter on 16 April 2024. In this letter (which you can download below), Maria Caulfield, Minister for Vaccines at the Department for Health and Social Care (DHSC):

• recognised the potential serious of disease caused by RSV and acknowledged it is a major cause of hospital admissions each winter
• noted that officials across DHSC, UK Health Security Agency (UKHSA) and NHS England are developing plans based on the JCVI advice
• stated that a final decision made and contracts awarded only if a full business case is approved. 

We did not hear back from the Chancellor of the Exchequer, though note the  that stated DHSC are responsible for the JCVI recommendations and “if any RSV programmes are agreed to, they will be announced to the public and health professionals in due course”.

The Lords Minister stated on 16 April 2024 that “the goal is absolutely to make sure that the JCVI advice is there for the key winter period”.

Campaign win

On 24 June 2024, NHS England and the UK Health Security Agency confirmed new respiratory syncytial virus (RSV) vaccination programmes from September 2024, for older adults and during pregnancy for infant protection.

In, NHS England confirmed that all women who are at least 28 weeks pregnant (the eligible cohort) on 1 September 2024, should be offered a single dose of the RSV vaccine, through commissioned services. After that, pregnant women will become eligible as they reach 28 weeks gestation and remain eligible up to birth. The new UK Government following the UK general election. 

Devolved governments

As in England, we have engaged civil servants and governments in the devolved nations on the need for an RSV vaccination programme. 

Scottish Chief Medical Officer Professor Sir Gregor Smith has for pregnant women and older adults, with a roll out beginning in August 2024.

Welsh Deputy Chief Medical Officer (Public Health) from September 2024. 

Northern Ireland has that from September 2024 all pregnant women and adults aged 75-79 will be offered the RSV vaccination. 

Frequently asked questions

For further information we have put together the following FAQs around the subject of the impact and effectiveness of the RSV vaccine for our members. Largely this is taken from the JCVI information page.

Where can I find further information for healthcare professionals?

The UK Health Security Agency (UKHSA) has for health practitioners implementing the vaccination programme to protect pregnant women and older adults from RSV. 

For Scotland, can be found here and ������.��

How should the UK Government roll out the JCVI recommended immunisation programme? 

As a College, we do not take a view on how the governments across the UK take forward logistics around procurement, their interactions with suppliers and pharmaceutical companies. This is not our role.

Instead, we take the overarching view that as the JCVI has used the evidence to make a recommendation to Government that there should be a programme rollout, then we are supportive of the rollout. We believe that since the recommendation was made in June 2023, then it should be appropriately progressed to ensure that those who would need the immunisation can receive it by winter 2024-25. 

What is the risk of RSV immunisation causing premature birth?

The JCVI’s advice flagged a potential increased risk of preterm births from a maternal vaccine, which have raised concerns from stakeholders about the safety of an RSV immunisation programme. However, the JCVI’s advice highlighted: 

• The clinical trial for the GSK maternal vaccine showed that an increase in preterm births was only observed in low-income countries (LICs) and not in high income countries (HICs). 
• The clinical trial for the Pfizer vaccine showed no excess of preterm birth in HIC, with the excess confined to upper middle-income countries (UMIC), South Africa and Brazil. 

The JCVI concludes a relative reassurance there is not an obvious signal of preterm births in HICs from a maternal RSV vaccine offer.

Will an RSV vaccination programme reduce infant and child mortality?

RSV is currently a leading cause of infant mortality globally and results in 20-30 deaths per year in the UK. It is the College’s view that an RSV immunisation programme would protect children’s health and reduce infant and child mortality, and we refer to JCVI’s analysis of the evidence to support this.

In our open letter, we referenced the JCVI statement and stated that a rollout “could result in 108,000 fewer GP consultations, 74,000 A&E visits and 20,000 fewer hospitalisations solely in those under one”. However, we would like to clarify that this is based on modelling data and as such is an approximation led by JCVI rather than concrete figures.

What is your position on the selected vaccination programme?

Our public campaign call was to implement a full vaccination programme for infants and adults in line with JCVI advice. We do not have a preference over which vaccination programme is best and defer to the JCVI who have advised that an RSV vaccination programme that is cost effective should be developed for both infants and older adults. 

What is the College doing on concerns that preterm infants wont be protected?

The College welcomes the announcement of the new vaccination programme for pregnant women to help reduce the morbidity and mortality associated with RSV infection in infants. However, due to the current criteria for vaccination (at least 28 weeks) set out by DHSC, we recognise that this could leave a vulnerable group of preterm babies unprotected.

Alongside the British Association of Perinatal Medicine (BAPM), we wrote to the Chair of the JCVI to ask that the JCVI considers the use of nirsevimab for all preterm babies <32 weeks gestation priority to discharge from hospital and for other high-risk neonates where mothers have not received RSV vaccine. 

What next

We welcome the announcements in England, Scotland, Wales and Northern Ireland. These programmes are a positive step in the right direction and you helped make them happen. The College will now engage with other relevant Royal Colleges as well as those in government and the civil service as these programmes are rolled-out.

We will keep this webpage updated with any further developments.