Respiratory syncytial virus, why is immunization not yet available in Italy? – WWN

It seems that the experience accumulated over the many years of the pandemic has not been implemented and put to good use with regards to the epidemic of respiratory syncytial virus (RSV)which represents the main cause of bronchiolitis and other childhood respiratory infections and usually causes major winter epidemics. Particularly in recent years we have witnessed peaks with need for hospitalization in neonatal/pediatric intensive care disproportionate compared to the availability of beds. In many European countries and regions, newborns and infants have had to be moved hundreds of kilometers away from home to care for them. From this year we have the possibility of carrying out universal, safe (passive) immunizationof all newborns and infants with a monoclonal antibody effective with a single administration throughout the winter season.

The antibody was approved by the FDA (Food and Drug Administration) and EMA (European Medicines Agency)in North America they are administering it universally. In Europe available, but in fact used patchily in the EU with serious and ethically questionable inequalities. France and Spain began their universal immunization campaign in September, Germany and Luxembourg follow shortly, but no other European country, including Italy, does so. Yet the drug approved for everyone and all newborns deserve to be protected. Certainly, unfortunately, they will not be for this 2023-2024 season. The reasons are many and all worrying, as reported in an article recently published on Lancet Regional Health – Europe by a group of experts. Between these: further steps at national or regional level, despite centralized European approval; the lack of a preferential implementation path; the lack of public information about RSV and the possible shortage of beds in pediatric/neonatal intensive care.

Excessive regionalization, in some aspects, of the healthcare system also plays a role whereas a more centralized system would respond more quickly to epidemic emergencies. But there are also other factors such as the relative lack of industrial production capacity and perhaps the lack of attention given to the problem even by us doctors. Rsv infections have a very low mortality, but children with concomitant diseases can die and in any case often require respiratory support in intensive care with consequences in terms of time, resources, costs, as well as anxiety and lost working days for parents. Despite the pandemic, therefore, European and Italian children do not have equal access to beneficial intervention suffering from discrimination that would be easily avoidable.

* Professor of Neonatology, Universit Paris Saclay; Pediatric Committee Ema (the opinions expressed are personal and in no case attributable to EMA or its internal structures)