Health Canada approves RSV vaccine for pregnant people

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It is the main reason babies under six months end up in hospital but, until now, there have been few options to protect babies from serious RSV (respiratory syncytial virus) infections. That is changing.

Last week, Health Canada approved a new vaccine aimed at protecting two of the groups most vulnerable to severe outcomes from the common virus: infants and older adults. Pfizer Canada’s vaccine, called Abrysvo, is the second vaccine approved for seniors aged 60 and older; the first, produced by GSK, was approved by Health Canada last year.

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But Abrysvo is also approved for pregnant people – the first vaccine aimed at protecting young babies through maternal vaccination.

“This is the first time we can help babies,” said Dr. Darine El-Chaar, a maternal-fetal physician at The Ottawa Hospital. “It is exciting.”

It works in the same way as other vaccines, including one against pertussis, by passing maternal antibodies to the fetus through the placenta, something that offers protection in the early stages of the newborn’s life.

That could be a game-changer, especially in parts of northern Canada that have one of the highest rates of RSV in the world, El-Chaar said. While there is usually a specific season for RSV in southern Canada (although the pandemic has shifted it slightly), RSV can circulate year-round in the far north, El-Chaar said.

“It can be quite devastating. Patients usually receive oxygen and need support with feeding. “It can mean a stay in hospital for a young family until their baby recovers from the lung infection.”

El-Chaar, who served on Canada’s vaccine advisory board, said she would like to see its cost covered for all pregnant people in Canada’s far north. Some of Nunavut’s sickest babies end up hospitalized in Ottawa, which is a tertiary health center for parts of Nunavut.

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The Abrysvo vaccine has not yet been recommended by NACI (the National Advisory Committee on Immunization), a necessary step before provinces make it available. El-Chaar said he hopes it will be available well before next year’s RSV season, and perhaps later this month.

It is part of a revolution in the treatment of RSV, a virus that many people had never heard of before 2022, when A spike in severe cases overwhelmed some pediatric hospitals and made headlines. When an adult contracts RSV, he or she usually suffers a mild, cold-like illness, but in babies with small airways, an initial infection can be serious.

In the fall of 2022, CHEO was among hospitals overwhelmed by the number of very sick babies, forcing it to create temporary intensive care units around the hospital. President and CEO Alex Munter previously said he visited one of those pop-up critical care units and was stunned to learn that the oldest child was only eight weeks old.

Until now, there has been antibody treatment for babies most at risk for poor outcomes from RSV, including premature babies with underdeveloped lungs and children with other health problems. That treatment, Palivizumab, is a monoclonal antibody that offers short-term protection to the most vulnerable. It is injected monthly during RSV season.

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Health Canada authorized another monoclonal antibody last April. Nirsevimab also offers passive immunity to infants and only needs to be given once per season, but is not yet available in Canada. In the United States, where it has been used, it is in short supply, El-Chaar said. It is longer lasting and less expensive than Palivizumab, he said.

El-Chaar said the attention RSV has received in recent years will make it easier for her to talk to pregnant patients about the vaccine to protect their newborns when the vaccine becomes available. This is largely due to the recent “triple diseases” of RSV, COVID and flu in 2022 and, to a lesser extent, 2023.

“We didn’t used to talk about it much. People only found out if she had an infected baby. But last year there were a lot of rumors about RSV due to the triple epidemic. However, it is unfortunate that we had to go through that.”

Details about who will be eligible to receive the vaccine and who will pay for it are not yet known.

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