Respiratory syncytial virus immunoprophylaxis: an underutilized preventive strategy in children with Down syndrome.

INTRODUCTION

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infection (LRTI) in young children, causing significant morbidity and mortality worldwide. Early life RSV LRTI adversely impacts the developing lung and immune systems, and has been linked to subsequent long-term respiratory sequelae. Children with Down syndrome (DS), with the combined attributes of structural and functional airway anomalies, immune dysregulation, and congenital heart defects are at heightened risk for increased RSV severity and may benefit from passive immunization of RSV immunoprophylaxis.

AREAS COVERED: This article reviews the evidence for the burden of RSV LRTI, the subsequent health sequelae of RSV LRTI, and the effect of RSV immunoprophylaxis in children with DS. The broader public health value of RSV immunoprophylaxis in improving health-related quality of life beyond RSV-associated short-term morbidity is explored. A systematic search of PubMed, Google Scholar, and MEDLINE on July 2025 was conducted.

EXPERT OPINION: New RSV prophylactic products have been demonstrated to be highly effective in reducing the risk of RSV LRTI in infants and certain high-risk children. Children with DS may benefit from these preventive strategies during early childhood by reducing respiratory and non-respiratory related disease burden and improving quality of life.