Manitoba not covering RSV treatments for newborns, pregnant people now recommended by federal agency

Manitoba is falling behind onrecommendations from a federal public health body to extend an RSV immunization programto help protect newborns and young children from the respiratory virus.

This spring, Canada's National Advisory Committee on Immunizationupdated its guidance on preventingrespiratory syncytial virus, or RSV, ininfants. The respiratoryvirus canaffectbreathing, and insevere cases, can lead to hospitalization.

NACI is recommending provinces prioritizevaccinating children at severe risk, but work toward"a universal RSV immunization program for all infants."

But Manitoba is lagging in implementing some of those recommendations for this RSV season.

Twotreatments recently approved by Health Canada and recommended by NACIare not listed under the province's free-of-charge immunization program.

Manitoba currently offerspalivizumab, a monthlyRSVantibody treatment, to young children identifiedat the highest risk from the illness, through the Health Sciences Centre's RSV prophylaxis program, a provincial spokesperson said.

According to NACI,palivizumab, approved by Health Canada for RSV prevention in infants in 2002,is a relatively expensive treatment.

The agency recommended in the spring thattwo new RSV immunizations authorized by Health Canada last yearbe used over palivizumab for infants: nirsevimab, an injectable monoclonal antibody treatment designed to protect children under 24 months from the virus, and RSVpreF, a vaccine for pregnant people starting their third trimester.

When the vaccine is given to pregnant people, the antibodies against RSVare transferred through placenta to the fetus, giving the infant "temporary protection"against the virus and preventing severe RSVin infants during their first months of life, NACI said.

The advisory committee said nirsevimab is the preferred RSV immunization option, based onits efficacy, duration and good safety profile.

The Canadian list prices for the nirsevimab and RSVpreF are $952 and $230 per dose, respectively.

Province says it 'continually reviews' vaccines

Dr. Philippe Lagac-Wiens, a medical microbiologist at Winnipeg's St. Boniface Hospital, said the recommended immunization against RSV is an "excellent strategy" to reduce the disease's severity.

"Focusing vaccination on those groups has had a significant impact in reducing the incidence of RSV-related hospitalizations by more than half," he said.

The province told CBC News it"continually reviews" vaccines, including the RSV vaccine, offered under its publicly funded immunization program.

The recommendations from NACI are "an important consideration" for the province, the spokesperson said, but other factors are also considered when determining whether a program is implemented in Manitoba.

Lagac-Wiens saida shortage of health-care providers, physiciansand nurses, paired with disease outbreaks, has likely forced the government to do "careful analysis" and prioritize strained resources.

He says universal RSV immunization campaigns for children, newborns,and pregnant people area priority, but acknowledgesManitoba's health-care system is dealing with other "critically important problems" that demand funding.

But offeringRSV immunization more broadly, especially in those groups at higher risk, might actually lead to"a substantial savings to the health system as a whole,"by curbingER admissions and other expenses related to treating RSV, he said.

"It may not need to be a universal vaccine" program, Lagac-Wiens said, but "these vaccines should be, at a minimum, offered to appropriate populations."

Ontario, Quebec make changes

Following Health Canada'sapprovals, Quebec will start offeringnirsevimabinjections to babies including those born after April 2 of the current year, as well as some older babiesat greater risk of serious complications.

Ontario has also expanded itsprevention program for this RSVseason by opening free coverage toall infants and high-risk children up to 24 months of age.It's also switchedtonirsevimabafter previouslyusingpalivizumab.

It will also makeRSVvaccination available to pregnant residents who are expected to have their babiesnearor during the 202425 RSV season.

Lagac-Wiens said the immunization programs in those provinceswill likely bring hospital admissions down.

AfterCOVID-19 pandemic restrictions eased, Manitoba saw a spike in serious childhood respiratory virus cases.

Lagac-Wiens said that while the symptoms of the virus in adults are similar to a mild illness, it carriesa "very high risk" ofsevere complications for babies under six months old, because theirimmune systems are notmature.

"RSV is a big problem," Lagac-Wiens said. "It really behooves us to do everything we can to try to reduce the strain on the health-care system, and it would include getting those vaccines."