Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias · 2025
Unequal impact of respiratory syncytial virus immunization in patients attending Spanish pediatric emergency departments.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Andina Martínez David, Barrueco Ramos Clara, Escalada Pellitero Silvia, Ranera Málaga Adrián, Guerra Díez José Lorenzo, Gimeno-Hernández Garza Verónica, González Arza Nerea, Ventura Pernia Juan, Sánchez Tatay Victoria, Ferrero García-Loygorri Clara, Miguel Lavisier Begoña de, Baños López Laura, Cámara Otegui Amaia, Gijón Mediavilla Manuel, Claret Teruel Gemma, Antonio Alonso-Cadenas José, Grupo de Trabajo sobre el Impacto de la profilaxis universal del Virus Respiratorio Sincitial en España
Аннотация
OBJECTIVE: To evaluate the impact of respiratory syncytial virus (RSV) prophylaxis with nirsevimab during its 2nd year of administration and analyze the differences between the different strategies implemented across Spanish autonomous communities (ACs) during the current epidemic season.
METHODS: We conducted a retrospective analytical study with 15 pediatric emergency departments across 9 ACs. We included all infants younger than 6 months who were treated in November, December, and January during 5 epidemic seasons (2018-2019, 2019-2020, 2022-2023, 2023-2024, and 2024-2025).
RESULTS: Compared with the average of epidemic seasons prior to the introduction of nirsevimab, in 2024-2025 there was a 65.5% decrease in episodes of acute bronchiolitis (95% CI, 64.3-63.7; P .001). Hospital admissions for bronchiolitis decreased by 74.7% (95% CI, 72.7-76.6; P .001), and PICU admissions fell by 72.9% (95% CI, 68.1-77.2; P .001). The reductions achieved in the 2024-2025 season were greater than those observed in the 2023-2024 season. The hospital from the AC that decided not to immunize infants born before the start of the epidemic had the worst outcomes. Among the ACs that applied the same strategy, worse outcomes were observed in the one that immunized out-of-season infants through selected hospitals rather than primary care centers.
CONCLUSIONS: Nirsevimab prophylaxis in Spain during the 2024-2025 season provided even greater protection vs RSV infection in infants younger than 6 months. However, differences across ACs were observed, likely related to the specific immunization strategies implemented.
METHODS: We conducted a retrospective analytical study with 15 pediatric emergency departments across 9 ACs. We included all infants younger than 6 months who were treated in November, December, and January during 5 epidemic seasons (2018-2019, 2019-2020, 2022-2023, 2023-2024, and 2024-2025).
RESULTS: Compared with the average of epidemic seasons prior to the introduction of nirsevimab, in 2024-2025 there was a 65.5% decrease in episodes of acute bronchiolitis (95% CI, 64.3-63.7; P .001). Hospital admissions for bronchiolitis decreased by 74.7% (95% CI, 72.7-76.6; P .001), and PICU admissions fell by 72.9% (95% CI, 68.1-77.2; P .001). The reductions achieved in the 2024-2025 season were greater than those observed in the 2023-2024 season. The hospital from the AC that decided not to immunize infants born before the start of the epidemic had the worst outcomes. Among the ACs that applied the same strategy, worse outcomes were observed in the one that immunized out-of-season infants through selected hospitals rather than primary care centers.
CONCLUSIONS: Nirsevimab prophylaxis in Spain during the 2024-2025 season provided even greater protection vs RSV infection in infants younger than 6 months. However, differences across ACs were observed, likely related to the specific immunization strategies implemented.