When Michelle Pratt gave birth to her premature twin sons at 32 weeks and four days, she was determined to shield them from illnesses like respiratory syncytial virus (RSV). RSV is a prevalent and highly contagious virus that targets the respiratory system, posing a significant risk to infants, potentially leading to hospitalization and, in rare cases, death.
“As a parent, you want to do everything possible to safeguard your children,” expressed Pratt, a dermatologist from St. John’s. She extensively researched medical literature during her pregnancy, relying on guidance from reputable organizations like the Canadian Pediatric Society and the National Advisory Committee on Immunization (NACI).
These expert groups uniformly recommend nirsevimab, known as Beyfortus, as the primary preventive measure against severe RSV for newborns and young infants. Nirsevimab, a monoclonal antibody approved by Health Canada in April 2023, offers protection for approximately five months with a single dose shortly after birth.
In a subsequent development, Health Canada approved a new bivalent vaccine called Abrysvo in early 2024. This vaccine is administered to pregnant individuals between 32 and 36 weeks of gestation to safeguard their infants during the initial six months post-birth.
Following NACI’s guidance, provinces are urged to progress towards a universal RSV immunization program for all infants. Most provinces have embraced this recommendation, providing varying degrees of coverage for nirsevimab.
However, only four provinces—Newfoundland and Labrador, Alberta, British Columbia, and New Brunswick—limit nirsevimab coverage to high-risk infants. These high-risk groups include children under two with chronic lung or congenital heart conditions and premature infants born at or before 30 weeks.
Despite the clear benefits of nirsevimab, some infants like Pratt’s sons do not qualify for publicly funded coverage due to stringent criteria. This exclusion has left parents like Pratt disappointed and eager for broader access to this standard of care.
Health-care professionals, including Dr. Shelley Ross, advocate for expanded access to RSV prevention measures, emphasizing that every infant deserves protection against RSV, irrespective of their geographic location. Dr. Ross views the introduction of RSV vaccines as a significant milestone in healthcare history.
Efforts by medical organizations and advocacy groups have led to positive outcomes in provinces that have adopted these preventive measures, resulting in a substantial decrease in hospitalizations and other severe outcomes related to RSV.
While some provinces have made strides in expanding coverage, Newfoundland and Labrador lag behind, with no immediate plans to broaden access to RSV prevention measures. Despite increasing RSV cases in the region, the province’s health authorities are yet to commit to universal coverage.
For families like Pratt’s, who seek the benefits of nirsevimab but cannot access publicly funded programs, the option of private purchase remains costly. Pratt highlights the disparity in access to RSV medications across provinces, stressing the importance of universal access to ensure equitable healthcare for all infants.
As efforts continue to advocate for expanded coverage and access to RSV prevention measures, the ultimate goal remains to protect all infants from the potential risks associated with RSV infections.