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Reduced Emergency Department Visits and Hospitalizations in Infants after Universal Respiratory Syncytial Virus
Insights
Universal nirsevimab immunization significantly reduced respiratory syncytial virus (RSV) hospitalizations and emergency visits in infants. This campaign effectively lowered the burden of severe RSV infections among young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Respiratory syncytial virus (RSV) poses a significant health burden on infants.
- Nirsevimab is a monoclonal antibody developed for RSV prevention.
- Universal immunization strategies aim to maximize population-level protection.
Purpose of the Study:
- To evaluate the effectiveness of a universal nirsevimab immunization campaign.
- To assess the impact on emergency department visits and hospitalizations for RSV and lower respiratory tract infections in infants.
- To compare outcomes in immunized infants with unvaccinated older children.
Main Methods:
- Utilized regional syndromic surveillance data for emergency department visits and hospitalizations.
- Employed interrupted time series analysis to estimate the expected disease burden based on historical trends.
- Compared outcomes in infants (<12 months) receiving nirsevimab with a control group of children aged 1-5 years.
Main Results:
- Infants experienced a 42.7% decrease in emergency visits and a 46.5% decrease in hospitalizations for acute lower respiratory tract infections.
- RSV-specific emergency visits decreased by 49.3% and hospitalizations by 55.0% among infants.
- No significant reductions in respiratory illness were observed in the unvaccinated 1-5 year old comparison group, indicating continued RSV circulation.
Conclusions:
- Universal nirsevimab immunization is highly effective in reducing severe RSV-related outcomes in infants.
- The findings support the implementation of widespread nirsevimab use for infant protection against RSV.
- Nirsevimab represents a valuable tool in public health strategies for controlling RSV disease burden.
Abstract:
During the 2024-25 winter season, a universal immunization campaign with nirsevimab was implemented in a region of Italy to prevent respiratory syncytial virus (RSV) infection among infants <12 months of age. We assessed its effects using regional syndromic surveillance data on emergency department visits (EDVs) and hospitalizations for lower respiratory tract infections and RSV infections. We estimated expected burden using an interrupted time series analysis, based on historical trends, and observed values with predictions. Children 1-5 years of age, not eligible for immunization, served as a comparison group. Among infants, EDVs for acute lower respiratory tract infections decreased by 42.7% and hospitalizations decreased by 46.5%, whereas EDVs for RSV infection decreased by 49.3% and hospitalizations decreased by 55.0%. No reductions were observed in children 1-5 years of age, confirming ongoing RSV circulation. Our findings support the effectiveness of universal nirsevimab immunization in reducing severe RSV-related outcomes among infants.
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