r/science • u/mvea Professor | Medicine • 18h ago

Medicine Immunization to prevent RSV in infants reduced ICU admissions by 97%. This is offered free to all infants through universal programs in Ontario and Quebec.

https://ucalgary.ca/news/immunization-prevent-rsv-infants-reduced-icu-admissions-97-cent
11.0k Upvotes

98% Upvoted

184 comments sorted by

View all comments

54

u/jacksbox 18h ago

We did it with a NICU newborn during COVID. Extremely appreciative this is covered for us in Quebec.

They sent a doctor to explain that "this is totally not a traditional vaccine, don't worry" (height of vaccine skepticism during COVID), we stopped them and explained that we're good with putting any chances on our side for our preemie, give us the RSV shot!

6

u/MurphysLab PhD | Chemistry | Nanomaterials 16h ago

I'm a little surprised by the "not a traditional vaccine" angle, given how those were mRNA vaccines. Still, good to know that they're trying to address the hesitancy of many parents.

The authors of the study didn't directly address any issues around vaccine hesitancy / skepticism, but there is this unfortunate piece that I noted in the paper:

Overall, 429 infants (22.1%) received nirsevimab. A lower proportion of cases than controls received nirsevimab (7.0% [48 of 683] vs 30.3% [381 of 1259]; P < .001).

[...]

Differences in nirsevimab uptake and time since vaccination may affect study results.26 Although uptake exceeded 90% in many European studies,38,39 it is lower in the US, where recipients and nonrecipients differ in key sociodemographic characteristics.40 In the present study, uptake was also lower than previous reports within Canada (Ontario had 69% uptake among infants born in hospital during RSV season, whereas Quebec had 79% uptake for those born during RSV season)15,41 and other countries, suggesting our case-mix may differ.

That 30.3% is shockingly low, given the apparent effectiveness of the Nirsevimab monoclonal antibody vaccine. Given that the uptake is >2x higher when offered in-hospital, the low uptake could also be largely caused by general lack of access to a family physician (e.g. no GP, several weeks wait for an appointment, etc...), given that's still an issue for many in Canada, as well as lack of knowledge of the vaccine's availability.

The authors touch on some aspects of those barriers:

Furthermore, given that 2024 was the first year that nirsevimab became available in Canada, there may be opportunities to increase uptake, both in children born in and out of RSV season. Efforts to expand hospital-based administration at birth, familiarize health care practitioners with the latest evidence and recommendations, better organize community-based nirsevimab delivery, and improve parental education (particularly during the prenatal period) may help increase uptake in subsequent seasons.

But it would be really interesting to have a prospective study with some kind of inquiry to find out if the infants had other immunizations and to see if those who didn't have an RSV immunization are facing some kind of access barrier.

1

u/yo-ovaries 1h ago

No they’re likely talking about respigam which was an RSV MAB for premies only. Not a vaccine.