Palivizumab vaccine for prevention of respiratory syncytial virus infection in children with cystic fibrosis

Respiratory syncytial virus (RSV) is a virus which commonly causes lung infections in infants and children. Although cases in most children are not severe, children with cystic fibrosis (CF) may be at higher risk for severe RSV lung infections. Children with CF are more likely to require hospitalisation and experience deterioration in lung function during a respiratory virus season, compared with children without CF. Palivizumab (Synagis®) is a vaccine which has been shown to reduce RSV hospitalisation rates in some high risk populations. Its effectiveness and safety in children with CF has not been established. We looked for randomised controlled trials comparing the use of palivizumab preventive therapy to either other preventive therapy or no preventive therapy in children with CF. We found one study with 186 participants (infants with CF up to two years of age). One infant (from 92) who received palivizumab and one infant (from 94) who received placebo were hospitalised due to RSV infection. No infants died. Overall, the number of adverse events in the palivizumab group was similar to that in the placebo group. No serious adverse events were reported to be related to the vaccine. Over the longer term (12 months), weight gain and number of infections with Pseudomonas aeruginosa (a common bacterial infection in CF) were similar between groups. The limitation of all these findings is that this was the only study we identified. More research is needed on the use of palivizumab prophylaxis in children with CF.