"With just one shot, parents can stop worrying about respiratory syncytial virus (RSV) infection for five to six months. Should we really let them give up vaccination because of the high cost?"
Chung Hae-il, a professor of pediatrics at Seoul Red Cross Hospital, made this remark in an interview with the Seoul Economic Daily on May 27. "While considering ways to provide practical help to vulnerable households raising infants and toddlers, we decided to subsidize RSV vaccination costs," he said.
RSV is a respiratory infection that typically circulates in Korea from October through March. While adults experience only mild cold-like symptoms, infants with weak immune systems and narrow airways can develop serious respiratory conditions such as bronchiolitis and pneumonia. Many cases that begin like a common cold progress to breathing difficulties within two to three days, sending children to emergency rooms or requiring hospitalization. Studies show that children under five years old are hospitalized or visit emergency rooms for RSV at rates approximately 16 times higher than for influenza. The virus is particularly dangerous for infants under six months old.
"More than 90% of children are infected with RSV at least once before reaching 24 months of age," Prof. Chung explained. "Nearly all infants and toddlers contract RSV at least once before their second birthday, and a significant number of these cases progress to bronchiolitis and pneumonia."
This risk applies equally to all babies regardless of underlying health conditions. In fact, approximately nine out of ten patients hospitalized for RSV infection are children who were born healthy. This means parents should take RSV prevention seriously even if their child was not premature or does not have heart or lung disease.
Synagis, an RSV preventive injection approved by Korea's Ministry of Food and Drug Safety in 2004, has been used only for high-risk infants such as premature babies and those with congenital heart disease. Because its protective effect lasts only about four weeks, patients typically receive five injections throughout the RSV season from October to March.
In contrast, Beyfortus, which became available in Korea in February last year, can be administered to all newborns and infants facing their first RSV season. Its protective effect lasts at least five months, requiring only a single dose before the RSV season begins. Despite costing between 500,000 won and 700,000 won ($360-$500) per dose, the vaccine has been in short supply due to surging demand. However, this price remains an insurmountable barrier for economically vulnerable families.
This prompted Seoul Red Cross Hospital to launch its RSV vaccination subsidy program in December last year. The program supports National Health Insurance subscribers with household income at or below the median level, basic livelihood security recipients, and near-poverty households. As the program is in its early stages, vaccinations are being administered primarily through partner facilities including shelters for unwed mothers and public health centers.
"Children in vulnerable facilities where mothers and babies live in group settings are highly susceptible to respiratory viruses like RSV," said Choi Yoon-ji, head of the public healthcare project team at Seoul Red Cross Hospital. "Vaccination reduces the probability of infection, leads to milder symptoms even when infection occurs, and helps prevent outbreaks within the facility."
RSV preventive injections function similarly to vaccines in preventing infection but work through a different mechanism. While vaccines introduce inactivated or weakened bacteria or viruses into the body to stimulate antibody production, Beyfortus and Synagis directly inject pre-made antibodies to provide immediate protection. This classification has slowed discussions about including RSV shots in the National Immunization Program.
"RSV does not affect any particular socioeconomic group more than others," Prof. Chung emphasized. "While Red Cross Hospital has begun supporting medically vulnerable populations, the government must quickly establish policies that allow all infants and toddlers to benefit."