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. 2022 Jul 7;48(7-8):363-366.
doi: 10.14745/ccdr.v48i78a08.

Summary of the National Advisory Committee on Immunization (NACI) statement update on the recommended use of palivizumab to reduce complications of respiratory syncytial virus infection in infants

Dorothy Moore  1 , Angela Sinilaite  2 , April Killikelly  2
Affiliations

Summary of the National Advisory Committee on Immunization (NACI) statement update on the recommended use of palivizumab to reduce complications of respiratory syncytial virus infection in infants

Dorothy Moore et al. Can Commun Dis Rep. .

Abstract

Background: Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infection in young children worldwide. Underlying health conditions, especially premature birth, chronic lung disease and congenital heart disease, predispose to severe RSV illness. The only means of prophylaxis against RSV disease is passive prophylaxis with the monoclonal antibody, palivizumab (PVZ) (SynagisTM). The National Advisory Committee on Immunization (NACI) published a statement for PVZ use in 2003. The purpose of this article is to update previous NACI recommendations for the use of PVZ, taking into consideration recent data on RSV burden of illness, effectiveness of PVZ in infants at risk of more severe RSV disease and economic implications of PVZ use.

Methods: The NACI Working Group and external experts performed systematic literature reviews on three topics to support updated NACI guidance: 1) RSV burden of disease; 2) PVZ effectiveness; and 3) cost effectiveness of PVZ prophylaxis. Full details and results are presented in the statement and supporting documents.

Results: Respiratory syncytial virus hospitalization (RSVH) rates are highest in children younger than one year of age and especially in the first two months of life. In various populations of infants at risk of severe RSV infection, PVZ prophylaxis is associated with reductions of 38%-86% in the risk of RSVH. Only rare cases of anaphylaxis have been reported after decades of use. Palivizumab is expensive and only cost-saving in rare scenarios.

Conclusion: Updated NACI recommendations on use of PVZ for the prevention of complications of RSV in infants are now available.

Keywords: NACI; National Advisory Committee on Immunization; PVZ; RSV; guidance palivizumab; respiratory syncytial virus.

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Conflict of interest statement

Competing interests: None.

References

    1. National Advisory Committee on Immunization. Statement on the recommended use of monoclonal anti-RSV antibody (palivizumab). Can Com Dis Rep 2003;29:1-15. https://publications.gc.ca/collections/Collection/H12-21-2-29-7.pdf - PubMed
    1. National Advisory Committee on Immunization. Advisory Committee Statement (ACS). Recommended use of palivizumab to reduce complications of respiratory syncytial virus infection in infants. Ottawa, ON: PHAC; 2022. https://www.canada.ca/content/dam/phac-aspc/documents/services/publicati... - PMC - PubMed
    1. Wingert A, Pillay J, Moore DL, Guitard S, Vandermeer B, Dyson MP, Sinilaite A, Tunis M, Hartling L. Burden of illness in infants and young children hospitalized for respiratory syncytial virus: A rapid review. Can Commun Dis Rep 2021. Sep;47(9):381–96. 10.14745/ccdr.v47i09a05 - DOI - PMC - PubMed
    1. National Advisory Committee on Immunization. NACI Literature Review on the Effects of Palivizumab Prophylaxis on Reducing the Complications Associated with Respiratory Syncytial Virus in Infants. Ottawa, ON. PHAC. Forthcoming 2022.
    1. National Advisory Committee on Immunization. Cost-effectiveness of palivizumab prophylaxis for respiratory syncytial virus (RSV): A Systematic Review. Ottawa, ON. PHAC. Forthcoming 2022.