"RSV changes the microbiome and when RSV takes over, you have dysbiosis. The ecology of the respiratory tract is disrupted."
In this expert interview, George Syrogiannopoulos, Professor of Pediatrics and Program Committee member of EIP, brings a dimension of RSV prevention that is often overlooked: the dangerous interaction between RSV infection and pneumococcal disease.
The science is compelling. RSV increases bacterial adhesion in the respiratory tract, making it easier for Streptococcus pneumoniae to attach, colonize and invade, raising the risk of secondary bacterial infection. Beyond this, RSV disrupts the respiratory microbiome itself, creating the conditions for dysbiosis that opens the door not just to pneumococcus but to a wider range of harmful bacteria.
He highlights the importance of close clinical observation when a child's condition changes over time, and the need for careful clinical judgment in managing these cases — and makes a strong case that coordinated RSV and pneumococcal vaccination is not just sensible but synergistic, with evidence from South Africa showing that pneumococcal conjugate vaccines also reduced RSV hospitalizations.
Key takeaway: RSV prevention is not just about RSV — protecting against it also helps protect the fragile ecology of the infant respiratory tract.
