Universal RSV immunization benefits outweigh the costs

Opinion

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This article was published 12/11/2024 (331 days ago), so information in it may no longer be current.

Dozens, potentially hundreds, of Manitoba infants will require hospitalization this winter for an illness that can be prevented by a medication being offered for free to infants in other provinces, but not here.

Last Thursday, it was reported that health experts are calling upon the Kinew government to offer RSV immunization shots for newborns amid a surge in hospitalizations of babies who have the highly contagious virus.

RSV — its full name is respiratory syncytial virus — causes infections of the lungs and respiratory tract. It can infect people of all ages, but is particularly dangerous for babies 12 months of age and younger, especially premature infants.

According to the National Institutes of Health, RSV is responsible for more than 100,000 deaths annually in children under five years old worldwide. Almost one-half of those deaths occur in children aged zero to six months, accounting for approximately four per cent of all deaths in children aged 28 days to six months old.

Over the past decade, a yearly average of 153 Manitoba children under two years of age were hospitalized with RSV infections. That number soared to 280 admissions in 2022-23, followed by 199 last winter — the third-highest number over the past 10 years. Each of those admissions occurred because a baby was in danger.

Canada’s National Advisory Committee on Immunization recommends that provinces and territories start “building towards a universal RSV immunization program for all infants.” Ontario, Quebec and Nunavut have moved much faster toward achieving that objective than Manitoba.

Those three jurisdictions are offering a single-dose medication called nirsevimab for all infants, at no charge. In Manitoba, however, fewer than 300 high-risk children under four years of age currently receive an anti-RSV medication — palivizumab — that is far more expensive than nirsevimab (prices for palivizumab range from $5,000 to $9,000 per child per season), and must be administered once a month.

Manitoba tried to switch from palivizumab to nirsevimab this year. That plan was unsuccessful, however, because the medication’s manufacturer, Sanofi, prioritized the provinces that offer universal programs.

When asked about Manitoba’s plans to offer nirsevimab through a universal program, Dr. Brent Roussin, Manitoba’s chief public health officer, emphasized that the national advisory committee only recommends “building towards” a universal program.

“We’re certainly looking at it,” he said, adding that the decision on whether to implement such program would require consideration of cost, resources, procurement and logistics of administration.

That’s not good enough, doctor.

Barbara Porto, an assistant professor in the department of medical microbiology and infectious diseases at the University of Manitoba, says that “It is critical that Manitoba fund this shot … It’s crucial to protect infants throughout the winter …it’s a huge burden for the health-care system across Canada.”

Epidemiologist Colin Furness, an associate professor at the University of Toronto, also says the RSV shot should be offered to all infants. He says that “one of life’s worst things” is to watch a baby struggling to breathe.

“Watching that kind of severe illness and thinking, ‘Wow, there’s a really easy way to avoid this,’ it makes it a really straightforward decision,” he added.

We agree. A universal RSV immunization program would better protect all Manitoba infants, and it would reduce the number of children hospitalized each year because of that terrible illness. It’s no exaggeration to say that such a program could be a life saver for some babies.

Some may be concerned about the potential cost of a universal RSV immunization program in Manitoba, but fewer infections would mean fewer hospital admissions. That would mean less stress on our overburdened health-care system, and would avoid the huge expense associated with in-hospital care for an infant. Those savings would go a long way toward paying for a universal program.

If the Manitoba government is “looking at” a universal immunization program, as Dr. Roussin claims, we encourage the government to look harder and work faster.

We are on the verge of yet another RSV season, with the well-being of Manitoba’s youngest and most-vulnerable children at risk. A universal RSV immunization program can reduce that risk. We owe it to our province’s children and their families to implement such program as soon as possible.