Related Experiment Video
Updated: May 29, 2025
Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
Changes in Care in Spanish Pediatric Emergency Departments After the First Immunization With Nirsevimab
Paula Vazquez-Lopez1, Aristides Rivas-Garcia1, Carles Luaces-Cubells2
1Pediatric Emergency Department, Gregorio Marañon University Hospital, Gregorio Marañon Health Research Institute, Madrid.
Insights
The introduction of nirsevimab significantly reduced pediatric emergency department visits and hospital admissions for respiratory syncytial virus (RSV) bronchiolitis. This monoclonal antibody also decreased intensive care unit admissions and the need for high-flow oxygen therapy.
Area of Science:
- Pediatric Emergency Medicine
- Infectious Disease Epidemiology
- Immunization Strategies
Background:
- Bronchiolitis, primarily caused by RSV, is a leading cause of pediatric hospitalizations.
- The implementation of nirsevimab offers a novel preventative strategy against severe RSV disease.
- Assessing the impact of nirsevimab on healthcare utilization is crucial for public health planning.
Purpose of the Study:
- To evaluate the effect of nirsevimab immunization on pediatric emergency department (PED) care during the bronchiolitis season.
- To quantify changes in healthcare burden indicators following nirsevimab introduction.
- To analyze the impact on hospital admissions, intensive care unit (ICU) occupancy, and resource utilization.
Main Methods:
- An observational, retrospective, multicenter study utilizing the Bronchiolitis Registry of the Spanish Society of Pediatric Emergency Medicine.
- Inclusion of data from 26-day periods across two bronchiolitis seasons (pre- and post-nirsevimab immunization).
- Comparison of healthcare burden variables between the two periods using descriptive statistics and Student t test.
Main Results:
- Significant reductions observed in PED visits for bronchiolitis (-41.6%) and related hospital admissions (-55.4%).
- RSV bronchiolitis admissions decreased by 60.3%, with an 81.3% reduction in ICU admissions.
- Decreased ICU occupancy (-30%), observation unit occupancy (-22.4%), inter-hospital transfers (-73.4%), and need for high-flow oxygen therapy (-60.9%).
Conclusions:
- Nirsevimab introduction led to a substantial decrease in the healthcare burden associated with pediatric bronchiolitis.
- The findings support the effectiveness of nirsevimab in mitigating the impact of RSV on pediatric healthcare systems.
- This study highlights the positive impact of monoclonal antibody prophylaxis on managing seasonal respiratory infections in children.
Objectives:
The aim of the study is to assess the changes in the pediatric care of patients seen in the Pediatric Emergency Departments (PED) during the bronchiolitis season following the introduction of immunization with a monoclonal antibody against RSV (nirsevimab).
Methods:
An observational, retrospective, multicenter study was conducted, analyzing the Bronchiolitis Registry of the Spanish Society of Pediatric Emergency Medicine. This registry, containing data on bronchiolitis cases, was initiated in December 2022. A total of 30 hospitals participated, all of which are members of the Spanish Society of Pediatric Emergency Medicine. Data from a 26-day period in 2 bronchiolitis seasons (2022: preimmunization and 2023: postimmunization) were included. Variables regarding health care burden were recorded for both periods. Quantitative variables were described using mean and SD, and the Student t test was used for comparisons between the 2 periods.
Results:
Twenty-five hospitals from 11 autonomous communities were included with a mean of 47,811 PED visits/year (SD: 26,675). The number of bronchiolitis cases presenting to the PED and bronchiolitis-related admissions decreased by 41.6%(95% CI: 34.9%-48.2%) and 55.4% (95% CI: 46.6%-64.2%), respectively, while admissions for RSV bronchiolitis decreased by 60.3% (95% CI: 51.9%-68.7%). Admissions to pediatric intensive care units decreased by 81.3% (95% CI: 57.9%-100%). Furthermore, the occupancy rate in the pediatric intensive care units decreased by 30% (95% CI: 22.8%-37.3%), while a reduction of 22.4% (95% CI: 13.2%-31.5%) was observed in the occupancy rate of observation units. The number of bronchiolitis cases transferred to other hospitals decreased by 73.4% (95% CI: 29.0%-100%). Finally, there was a 60.9% (95% CI: 26.5%-95.3%) reduction in the need for high-flow oxygen therapy among bronchiolitis patients.
Conclusions:
After the introduction of nirsevimab, a large portion of indicators related to the burden of care associated with bronchiolitis during its epidemic season decreased significantly.
More Related Videos
Related Concept Videos
01:51Vaccinations
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:23Immunological Memory
What is Immunological Memory?
Immunological memory is an integral function of the immune system that allows it to recognize and react more rapidly and effectively to pathogens previously encountered. This feature...
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...