RSV vaccine could ‘change the landscape’ of hospital presentations

From next month, West Australian babies will have free protection against the potentially life-threatening, but now preventable, respiratory syncytial virus (RSV), thanks to a new statewide vaccine rollout.
 
The $11 million State Government commitment to provide infants under eight months access to the nirsevimab (Beyfortus) vaccine is the first of its kind in the southern hemisphere, and RACGP WA Chair Dr Ramya Raman said the move represents a ‘real boost’ to combatting the virus.
 
‘I welcome the Government acting decisively to help protect children from the worst effects of this virus,’ she said.
 
‘RSV must be taken seriously. It is the number one cause of hospitalisation for children aged five and under in Australia, with a quarter of these children needing intensive care.
 
‘So, in addition to being a horrible experience for families, the virus places a tremendous strain on our entire healthcare system, including our hospitals.’
 
Clinical trials indicate nirsevimab can result in an 83% reduction in the number of children hospitalised with RSV, with Dr Daniel Yeoh, infectious diseases paediatrician at the Perth Children’s Hospital, calling it a ‘game-changer’.
 
‘The vaccine is effective and importantly safe … and is potentially going to change the landscape of respiratory illness we see in hospital,’ he said.
 
Dr Yeoh also predicts the initiative will have major preventive health benefits and would like to see the initiative taken up in other parts of the country.

‘It’s encouraging that it has been approved in WA,’ he said. ‘Hopefully other states will follow suit.’
 
In children, RSV is the leading cause of the asthma-like condition, bronchiolitis. And while most bronchiolitis is only mild and does not require medical treatment, with symptoms resembling a common cold, it can also cause serious respiratory illness requiring hospitalisation and even treatment in a paediatric intensive care unit.
 
The disease hospitalises approximately 6000 Australian children each year, with 1000 hospitalisations in WA alone.
 
In addition to infants under eight months becoming eligible for RSV immunisation at general practices, community health clinics and Aboriginal Medical Services that provide childhood immunisations, as well as those at increased risk of severe RSV aged 8–19 months will also have access.

The news will be particularly welcome to Australians living in rural and remote communities, who often experience the worst physical, economic and social effects of the illness.
 
Compared with those in major cities, rural children are often required to travel vast distances to seek urgent care for respiratory infections, leading to delays in presentation for vital emergency care.
 
Smaller rural hospitals may likewise not have intensive care units to best care for those with severe infections, which can lead to further delays in and stressful periods waiting for the arrival of transport services.
 
Associate Professor Michael Clements, Chair of RACGP Rural and the college’s Vice President, maintains that he is ‘very excited to see the rollout across the country’ and its impact on ‘reducing the burden [of RSV] on families, the health system and retrieval services’.
 
The Rural Chair is advocating for the rollout in other states alongside WA to ‘improve interstate variability of vaccination against common pathogens’, while also calling for it to be prioritised across rural and remote areas.
 
Associate Professor Clements highlights that even mild-to-moderate bronchiolitis has its own uniquely frustrating impact on rural communities. He recounts that he and other rural generalist colleagues have had to even airlift children with only moderate symptoms to metropolitan hospitals to ensure their ongoing safety.
 
This is because the appropriate treatment available in a remote hospital with limited resources cannot be guaranteed should the child’s condition suddenly deteriorate.
 
Ideally, widespread vaccination will reduce not just the physical effects of the illness itself on children, but also the immense cost of such hospital transfers. Airlifting sick children across the state is not only distressing but is also highly disruptive for the entire family.
 
Parents in remote communities are often faced with the horrible conundrum of who will be there to look after the rest of the kids if they accompany their sick child being retrieved ‘to town’?
 
One can only hope the vaccine will soon be rolled out in other states in a united effort to ensure that kids stay safe from preventable illnesses across Australia, no matter the postcode.
 
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Beyfortus nirsevimab respiratory RSV syncytial vaccination virus Western Australia