Prevention of infant death is a global priority but is most urgent in low- and middle-income countries (LMICs), where nearly 95% of the deaths occur and where access to alternative prevention strategies is most constrained. RSV is a major cause of viral pneumonia in young children and in LMICs, causing more than 100 00 child deaths every year and the hospitalization of 1.4 million infants aged under 6 months.3 Although long-acting monoclonal antibodies could also prevent severe RSV disease in infants, their high cost and delivery requirements will limit their introduction into LMICs in the near future. GBS, a bacterial disease, is a leading cause of neonatal sepsis, meningitis, infant death, and stillbirth; each year, GBS causes an estimated 90 000 newborn and infant deaths, as well as 46 000 stillbirths.4 Prevention strategies, such as intrapartum antibiotic prophylaxis, are challenging to deliver in LMICs and are unlikely to prevent GBS-associated stillbirth or late-onset disease. Maternal vaccines are thus a key intervention to prevent both RSV and GBS disease early in life.
AUTHOR CONTRIBUTIONS
All listed authors have been involved in the production of this FIGO editorial. All authors have contributed to the structure, drafting and analysis of data included in this editorial, have reviewed and provided feedback on draft versions of the article, and have approved the final version for publishing. Copies of the individual authors’ comments, feedback, and reviews are available upon request.
FUNDING INFORMATION
The following MIRNA co-authors and investigators have received funding from the Gates Foundation to advance the work of MIRNA (INV-063462): Hellen Barsosio, Michelle J. Groome, Shifa S. Habib, Hadiza S. Galadanci, Eve Nakabembe, and Annettee Nakimuli.
CONFLICT OF INTEREST STATEMENT
Anna C. Seale and Kate Fay are employees of the Gates Foundation. Hellen Barsosio, Michelle J. Groome, Shifa S. Habib, Hadiza S. Galadanci, Eve Nakabembe, and Annettee Nakimuli are Maternal Immunization Readiness Network in Africa and Asia (MIRNA) investigators and have received funding from the Gates Foundation to advance the work of MIRNA. The remaining authors have no conflicts to declare.