Home Immunization with Palivizumab-A Randomized Pilot Study Describing Safety Aspects and Parents' Preferences

Area of Science:

• Pediatrics
• Immunology
• Public Health

Background:

• Respiratory syncytial virus (RSV) infections pose significant risks for premature and chronically ill infants, potentially leading to hospital readmissions and respiratory issues.
• Palivizumab, a monoclonal antibody, offers therapeutic protection against RSV through monthly injections during the RSV season.
• Current standard care involves multiple clinic-based injections, increasing hospital revisits and exposure risks for vulnerable infants.

Purpose of the Study:

• To evaluate the safety and parental preferences of home versus hospital administration of palivizumab in high-risk infants.
• To explore the feasibility of home-based immunization as an alternative to clinic-based standard care.

Main Methods:

• A randomized pilot trial involving 43 infants from 38 families was conducted over one RSV season.
• Safety was assessed by monitoring immediate adverse events (AEs) by nurses and late-onset AEs reported by parents.
• Parental perceptions and preferences were gathered through questionnaires and analyzed using content analysis.

Main Results:

• No immediate adverse events were observed during home or hospital immunization.
• Three late-onset AEs were reported in two infants within the home immunization group.
• Content analysis revealed parental themes centered on infant protection, family well-being, and minimizing infant suffering.

Conclusions:

• Home immunization with palivizumab is a feasible and safe option for vulnerable infants when safety considerations are addressed.
• Parental involvement in choosing the immunization setting, particularly after neonatal intensive care, is crucial for optimizing care and well-being.