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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Pediatric RSV-Protection and Social Risk in Three Academic Primary Care Centers
Mary Carol Burkhardt1, Melissa E Day2, Anne K Jackson3
1Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Insights
Respiratory Syncytial Virus (RSV) protection increased in infants during the 2023-24 and 2024-25 seasons. Infants with positive social risk factors were more likely to receive RSV protection, indicating potential for equitable health outcomes.
Area of Science:
- Pediatric Infectious Diseases
- Public Health
- Health Equity
Background:
- Respiratory Syncytial Virus (RSV) poses a significant health burden on infants.
- The availability of RSV therapeutics presents an opportunity to improve protection rates.
- Understanding disparities in access to preventative measures is crucial for equitable health outcomes.
Purpose of the Study:
- To investigate the association between social risk and Respiratory Syncytial Virus (RSV) protection in infants.
- To analyze trends in RSV protection and its relationship with social determinants of health during the 2023-24 and 2024-25 seasons.
- To assess the impact of novel RSV therapeutics on equitable protection among diverse infant populations.
Main Methods:
- Retrospective study utilizing electronic health records from three pediatric primary care practices.
- Inclusion criteria: infants under 8 months during RSV seasons, with documented RSV protection status (nirsevimab or maternal vaccination).
- Statistical analysis included Chi-squared tests and multivariable logistic regression to assess associations between social risk, sociodemographic factors, and RSV protection.
Main Results:
- RSV protection increased from 47.7% in 2023-24 to 60.5% in 2024-25 (p<0.001).
- Infants with positive social risk screens were more likely to receive RSV protection in both seasons (p=0.018 in 2023-24; p=0.007 in 2024-25).
- After adjustment, positive social risk remained associated with higher odds of RSV protection (OR 1.25-1.36).
Conclusions:
- RSV protection rates significantly improved between the 2023-24 and 2024-25 seasons.
- Social risk factors were positively associated with receiving RSV protection, suggesting these therapeutics may be reaching vulnerable populations.
- These findings support the potential for novel RSV therapeutics to promote more equitable health outcomes.
Objective:
To examine the relationship between respiratory syncytial virus (RSV) protection and social risk in infants during the 2023 to 24 and 2024 to 25 seasons, when RSV-therapeutics were available.
Methods:
We conducted a retrospective study across 3 academic pediatric primary care practices. Electronic health records were used to identify infants (<8 months during RSV-season), RSV-protection-status (nirsevimab receipt or reported maternal RSV-vaccination), social-risk screening results administered to caregivers, and sociodemographic characteristics. Covariates included season, sex, age, race, ethnicity, insurance, and community material deprivation. Chi-squared tests and multivariable logistic regression assessed associations between such factors and RSV-protection-status.
Results:
A total of 1653 and 1692 infants were eligible in the 2023 to 24 and 2024 to 25 seasons, respectively (49.0% female, 65.0% Black, 11.3% Hispanic, 82.7% publicly insured). RSV-protection increased from 47.7% to 60.5% across seasons (P<.001). In 2024 to 25, RSV-protection occurred at an earlier age (46 vs 54 days; P = .022), and maternal vaccination rose (6.3% vs 1.6%; P<.001). Black, non-Hispanic infants were less likely to be RSV-protected. RSV-protected infants were more likely to have positive social risk screens (53.8% vs 46.2%, P = .018 in 2023 to 24; 63.4% vs 36.6%, P = .007 in 2024 to 25). After adjusting for age, sex, race, ethnicity, insurance, and deprivation index, a positive social risk screen was associated with RSV-protection (2023-24: OR 1.25 CI, 1.01-1.55, P = 0036; 2024-25 OR 1.36, CI 1.10, 1.67, P = .004).
Conclusions:
RSV-protection increased between the 2023 and 24 and 2024 and 25 seasons. Positive social risk was linked to higher RSV-protection, suggesting that novel RSV-therapeutics might enhance promotion of equitable RSV-related outcomes.
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