Alberta is set to introduce a no-cost preventative RSV vaccination for select high-risk newborns this autumn, although it will not extend universal coverage to all infants, a move some provinces are embracing. The antibody shot, nirsevimab (marketed as Beyfortus), received approval from Health Canada in 2023, with several provinces opting to administer it to all newborns. This single-dose injection contains synthetic proteins that mimic those produced by the body’s natural immune system.
Commencing in November, the nirsevimab injection will supplant the monthly Palivizumab (Synagis) shot, which was previously offered to certain high-risk infants. In 2024, the National Advisory Committee on Immunization recommended that provinces work toward implementing a universal RSV immunization program for all infants, identifying nirsevimab as the preferred choice. The committee suggested that programs could be phased in based on factors such as supply, cost-effectiveness, and financial feasibility.
Ontario and Quebec initiated the provision of the antibody shot to all newborns last year. Additionally, Saskatchewan, Manitoba, P.E.I., and Nova Scotia have revealed expanded coverage plans for the upcoming respiratory virus season. Nunavut, the Northwest Territories, and Yukon also provide coverage.
Contrary to the universal approach adopted by other provinces, Alberta has opted for a targeted strategy in offering nirsevimab. At Alberta Children’s Hospital, Dr. Sidd Thakore, a pediatrician, anticipates a busy RSV season as cases begin to emerge. While pleased with the government’s decision to offer nirsevimab to high-risk infants, Thakore advocates for broader coverage to include all at-risk children.
RSV, a virus that commonly causes mild cold-like symptoms, can lead to severe illness in young children and older adults, necessitating hospitalization and ICU admission. Reichert, a neonatologist in Edmonton, expressed concern that not all vulnerable babies are being protected, emphasizing the susceptibility of newborns due to their underdeveloped immune systems and small airways.
The Alberta government stated that it is closely monitoring RSV trends. While acknowledging the potential for severe illness in specific high-risk groups, the government emphasized that RSV results in fewer severe outcomes at the general population level, a crucial factor in evaluating broader immunization programs. According to the National Advisory Committee on Immunization, RSV causes significantly more hospitalizations in young children than influenza.
Nirsevimab has demonstrated an 81 to 83 percent reduction in hospital admissions linked to RSV, as per the Canadian Immunization Guide. The government is conducting a cost-effectiveness and feasibility analysis to guide decisions for the upcoming respiratory virus season. Doctors are increasingly concerned about hospitals’ capacity to manage surges during the respiratory virus season, underscoring the potential benefits of universal nirsevimab coverage in alleviating pressure on healthcare facilities.
