Making Combination Vaccines Work in the Real World: Expert Insights on RSV, hMPV and PIV

Posted on Apr 17, 2025

As combination vaccines targeting respiratory viruses like RSV, hMPV, and PIV move closer to becoming a reality, there remain crucial questions around epidemiology, durability, and safety. In Airfinity’s recent webinar, “From Science to Strategy: Making RSV, hMPV and PIV Vaccines Work in the Real World,” a panel of global experts explored these challenges and opportunities in depth.

Moderated by Airfinity’s Senior Epidemiologist Selina Kim, the discussion brought together Dr. Marco Cavaleri, Head of Biological Health Threats and Vaccines Strategy at the European Medicines Agency (EMA); Mark Jit, Chair and Professor at the Department of Global and Environmental Health NYU School of Global Public Health; and Emmanuel Hanon, CEO of Vicebio; to share their perspectives on what it will take to make these vaccines viable and impactful across diverse populations and geographies.

Balancing Safety with Benefits: Regulatory Perspective

As combination vaccines become more complex, so too does the safety landscape. EMA’s Dr. Marco Cavaleri underlined the importance of real-world monitoring and the need to contextualise risk.

“Safety is always extremely important and paramount in our evaluation as a regulatory body. We need to understand the incidence of adverse events and how they affect the benefit-risk balance. Pre-approval clinical trials won’t capture very rare events, so post-approval studies are key. Importantly, we also need to weigh the risk of side effects against the potential for the vaccine to prevent those very same conditions—such as neurological complications from viral infections themselves. It’s not about eliminating all risk, but understanding it in the right context.”

One Virus Doesn't Fit All: The Challenge of Seasonality

Professor Mark Jit explored the logistical and economic complexity of synchronising vaccination strategies for viruses with different seasonal patterns.

“Seasonality plays a role in determining cost-effectiveness. In countries with distinct, predictable RSV seasons, a seasonal vaccination strategy might work well. But if you’re thinking about a combination vaccine, the challenge becomes even more complex. You need to cover multiple viruses, which may not peak at the same time. Even within countries—take China, for example—different regions may experience different seasonality. That means you might need different guidelines depending on the region. Implementing that level of granularity is hard, but necessary if we want strategies that are both effective and feasible.”

Designing for Durability: A Win for Public Health Systems

For Dr. Emmanuel Hanon, durability is the linchpin of successful combination vaccines - reducing the need for seasonal campaigns and expanding global accessibility.

“If you can demonstrate that your vaccine offers multi-year protection, everything changes. You don’t need seasonal manufacturing runs. You don’t need country-by-country tailoring. You can centralize production and distribute globally, using a shelf-stable product that can be given any time of year. That’s a huge win not just for manufacturers, but for healthcare systems. The key is designing vaccines that generate strong, cross-reactive immunity—more than what you get from natural infection. For RSV, we’ve already seen multi-year protection is achievable. Now we’re working to bring that same durability to hMPV and PIV.”

Looking Ahead

The development of combination vaccines against RSV, hMPV and PIV represents a turning point in respiratory virus prevention. But real-world success will depend on smart rollout strategies, regulatory clarity, and a shared understanding of how to balance scientific ambition with global feasibility.

To dive deeper into the conversation, watch the full webinar below.

Reach out to contact@airfinity.com if you have any questions or would like more insights on combination vaccine forecasting!

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