Fewer babies admitted to hospital after Quebec’s first RSV immunization campaign

Doctors say last year’s rollout of Quebec’s first RSV immunization program helped prevent thousands of infant hospitalizations.

The number of infants being admitted to hospital with complications from respiratory syncytial virus (RSV) has gone down dramatically since Quebec implemented its first immunization campaign last fall, according to Santé Quebec.

“Expert reports have shown that it is important to protect our youngest babies against this respiratory virus, which can often lead to complications and other illnesses,” said Martine Leblanc-Constant, director of public health operations at Santé Québec.

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Last year, Quebec administered more than 56,000 doses of Nirsevimab, which provides passive immunity by directly delivering antibodies, almost double the initial goal of 30,000 immunizations.

“Nearly 75 per cent of babies born during the circulation of the virus were successfully administered the product,” said Leblanc-Constant. “We were really pleased with the preliminary reports...showing that the risk of hospitalization and ER visits was reduced by 90 per cent, which was really, really important to us.”

That decrease is significant, according to Santé Quebec, particularly among babies under six months old.

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“Babies have little means of defending themselves if they have older brothers or sisters at home who will be going to school or daycare,” said Leblanc-Constant. “It is a virus that spreads quickly. So, this new product, which is safe, is really the best way to protect against infection and complications.”

Dr. Jesse Papenburg, a pediatric infectious disease specialist and medical microbiologist at the Montreal Children’s Hospital, points out that RSV is the leading cause of hospitalizations for babies under the age of one in Canada.

“In young babies, they don’t have any immunity, and it gets down into the lungs where it can cause bronchiolitis, a plugging of the small airways of the lungs or pneumonia,” he said.

Papenburg explains that RSV is a seasonal virus that circulates widely between late October and early April, and notes that most newborns are inevitably infected by an older sibling.

“We estimate that in Canada, about one to two per cent of all babies will actually require hospitalization due to RSV,” he said. “Among those babies that do get hospitalized, somewhere between five and 15 per cent will go to the intensive care unit.”

Santé Québec says it is currently planning its 2025-2026 immunization campaign, set to kick off on Sept. 30.

Is your baby eligible?

The respiratory syncytial virus (RSV) immunization provides babies with pre-made antibodies to protect them from severe infection.

“It probably reduced the burden of RSV by about 1,000 hospitalizations in the province of Quebec last year, and probably avoided approximately 100 ICU admissions due to RSV,” said Papenburg. “So really, at the population level, also big benefits for the health care system by using this product that’s very safe and highly effective.”

It is free during the RSV immunization campaign, in fall and winter, for babies:

• born on or after April 2 of that year;
• who have a higher risk of complications and were born on or after Feb. 2 of that year, namely, babies born before 37 weeks or have a condition that could increase the risk of complications.

“It is a product that is specifically designed for babies to protect them directly from respiratory viruses, which tend to be less complicated in older children,” explains Leblanc-Constant. “It is really the youngest babies who are at risk of developing complications.

Babies born during the fall and winter months can receive the immunization at birth.

Some babies may be eligible for a second dose, depending on their health.

Am I eligible?

Some adults are also eligible for free immunization against RSV, including those:

• aged 60 and over living in a CHSLD or RI-SAPA;
• aged 75 and over living in an RPA.

The immunization is recommended, but not free, for people 18 years or older who have had a hematopoietic stem cell or lung transplant in the last two years.

It is authorized, but not free, for:

• pregnant women between the 32nd and 36th week of pregnancy (to protect the baby);
• those aged 60 years and older;
• those aged 50 years and older at risk of complications from RSV.

Signs of illness

Some of the signs of an RSV complication, according to Papenburg, include:

• Congestion of the upper airways;
• Wheezing
• Difficult or fast breathing (look for flaring nostrils in babies);
• Tugging near the collarbone or in between the ribs (also known as chest wall retractions, where the baby is trying to use the muscles between the ribs or neck to breathe).

“Some babies also will have difficulty drinking because they’re breathing hard and they’re spending a lot of their energy on that, and they may become dehydrated,” he said. “You’ll see that if a baby’s not producing urine as much, that’s another sign that they might be dehydrated and also would require medical attention.”

Some children with RSV can present with a fever, but Papenburg points out it’s not one of the predominant signs.