Peer-reviewed article
From Selective Prophylaxis to Broad Infant RSV Protection: A Bibliometric Analysis and Evidence Gap Map, 1998–2025
Zhongyuan Li, Qiuhong Wang, Ruixia Liu, Xiaohong Hu ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study maps research on preventing respiratory syncytial virus (RSV) in infants, covering 1998 to 2025. It analysed 2004 publications in the Web of Science and 1227 original studies for evidence gaps. Research moved from palivizumab for selected preterm infants toward long-acting monoclonal antibodies such as nirsevimab and maternal vaccination, and output rose sharply after 2022. Hospitalisation, disease burden and real-world effectiveness are well studied. Uptake, acceptance, equity, safety monitoring, economic evaluation, relevance to low- and middle-income countries, and coordination of maternal vaccination with infant antibodies are studied less.
Key points
- The bibliometric corpus had 2004 publications; 1227 studies were used for evidence-gap mapping.
- 2023-2025 accounted for 35.0% of the bibliometric corpus.
- Earlier work focused on palivizumab, preterm infants and hospitalisation; recent work addresses nirsevimab, maternal vaccination, implementation and vaccine candidates.
- Coverage/uptake, acceptance, equity, safety monitoring, economic evaluation and applicability to low- and middle-income countries were less common.
- Validation of relevance screening on 150 articles showed 86.7% agreement (Cohen's kappa = 0.52).
Limitations
This is a literature mapping based on one database (Web of Science Core Collection), so it does not show whether any RSV prevention strategy works. Screening agreement was only moderate (kappa 0.52), and the abstract does not name the countries the studies cover.
Abstract
OBJECTIVES: Infant respiratory syncytial virus (RSV) prevention has moved from selective palivizumab prophylaxis toward broader protection through long-acting monoclonal antibodies and maternal vaccination. We examined how this research area evolved and whether original studies address evidence needed for implementation at scale. MATERIALS AND METHODS: We conducted a bibliometric analysis and evidence-gap mapping study of Web of Science Core Collection records from 1998 to 2025. The bibliometric corpus included 2004 publications; 1581 original articles underwent relevance screening and targeted audit, yielding 1227 studies for evidence-gap mapping. Analyses compared 1998-2022 with 2023-2025. A random sample of 150 articles was used to validate relevance screening. RESULTS: Publication output rose sharply after 2022, with 2023-2025 accounting for 35.0% of the bibliometric corpus. Earlier work centered on palivizumab, preterm infants, and hospitalization; recent studies increasingly addressed nirsevimab, maternal RSV vaccination, implementation, and vaccine candidates. Hospitalization outcomes, disease burden, monoclonal antibody strategies, and real-world effectiveness were well represented, whereas coverage/uptake, acceptance, equity, safety monitoring, economic evaluation, applicability to low- and middle-income countries, and coordination between maternal vaccination and infant monoclonal antibodies were less common. Validation showed 86.7% agreement (Cohen's kappa = 0.52). CONCLUSIONS: The literature has shifted toward broad infant RSV protection, but implementation-relevant evidence remains uneven. Comparative and program-level research is needed to determine how maternal vaccination and infant monoclonal antibody strategies can be implemented and coordinated across health systems while minimizing missed opportunities for protection.