Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Instagram
  • Listen to CMAJ podcasts
Letters
Open Access

Respiratory syncytial virus and palivizumab prophylaxis in the COVID-19 era

Richard S. Taylor
CMAJ April 12, 2021 193 (15) E523; DOI: https://doi.org/10.1503/cmaj.78240
Richard S. Taylor
Neonatologist, Victoria General Hospital, Victoria, BC
MB BS
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

Across Canada, both influenza and respiratory syncytial virus (RSV) have been almost completely absent during the 2020/21 winter. 1 Data from the Southern hemisphere showed the same phenomenon following the implementation of public health measures for coronavirus disease 2019 (COVID-19).2 Despite the low incidence of RSV, programs across Canada have continued to promote the administration of palivizumab (PVZ) prophylaxis to eligible infants at a cost of about $1500 per dose. Canadian taxpayers are currently on track to spend nearly $50 million on a drug3 unlikely to have any benefit this winter.

In 2017, Mitchell and Peiris4 correctly pointed out that the social determinants of health need to be addressed when considering the effectiveness of PVZ prophylaxis for infants in the Artic with RSV.5 If they have not already done so, all Canadian PVZ programs need to immediately stop prophylaxis. Prophylaxis guidelines should be reviewed, with a switch to a flexible response to RSV activity. Palivizumab is an antibody, so unlike a vaccine, it becomes effective within hours of injection. Its administration can surely wait until there is significant risk of community-acquired RSV.

What will happen when COVID-19 rules are lifted? Will it become a societal norm to wash hands, wear a mask in crowded places, use hand sanitizer and avoid school or work for upper respiratory tract infections? We do not yet know. In Australia, there have been recent summer spikes in RSV activity,6 possibly related to a reduction in social distancing. Now that we have rediscovered a far more effective approach to infant hospital respiratory admissions, it would be foolish to assume that life will quickly return to normal. Prophylaxis programs for RSV will need to adjust to the new reality.

Footnotes

  • Competing interests: Richard Taylor was chair of the British Columbia Respiratory Syncytial Virus Immunoprophylaxis Committee.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.e., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.org/licenses/by-nc-nd/4.0/

References

  1. ↵
    Respiratory virus detections in Canada. Ottawa: Government of Canada; 2021. Available: www.canada.ca/en/public-health/services/surveillance/respiratory-virus-detections-canada.html (accessed 2021 Jan. 29).
  2. ↵
    1. Yeoh DK,
    2. Foley A,
    3. Minney-Smith CA,
    4. et al
    . The impact of COVID-19 public health measures on detections of influenza and respiratory syncytial virus in children during the 2020 Australian winter. Clin Infect Dis 2020 Sep 24 [Epub ahead of print]. doi: 10.1093/cid/ciaa1475.
    OpenUrlCrossRef
  3. ↵
    1. Crowe K
    . Provinces spent $43M on preemie drug experts say can be made for a fraction of the cost. CBC News 2017 Apr. 6. Available: www.cbc.ca/news/health/rsv-drug-synagis-palivizumab-premature-infants-abbvie-provinces-health-care-1.4056823 (accessed 2021 Jan. 29)
  4. ↵
    1. Mitchell I,
    2. Peiris D
    . Reducing the burden of lower respiratory tract infections in infants in the Canadian Arctic. CMAJ 2017;189:E450–1.
    OpenUrlFREE Full Text
  5. ↵
    1. Gilca R,
    2. Billard M-N,
    3. Zafack J,
    4. et al
    . Effectiveness of palivizumab immunoprophylaxis to prevent respiratory syncytial virus hospitalizations in healthy full-term <6-month-old infants from the circumpolar region of Nunavik, Quebec, Canada. Prev Med Rep 2020;20:101180.
    OpenUrl
  6. ↵
    1. Slezak M
    . Sharp rise in RSV infections among children has experts warning parents not to relax COVID-19 social distancing measures. ABC News 2020 Dec. 5. Available: www.abc.net.au/news/2020-12-06/sharp-rise-in-rsv-infections-among-children-covid-19-risk/12945930 (accessed 2021 Jan. 29)
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 193 (15)
CMAJ
Vol. 193, Issue 15
12 Apr 2021
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Respiratory syncytial virus and palivizumab prophylaxis in the COVID-19 era
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Respiratory syncytial virus and palivizumab prophylaxis in the COVID-19 era
Richard S. Taylor
CMAJ Apr 2021, 193 (15) E523; DOI: 10.1503/cmaj.78240

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Respiratory syncytial virus and palivizumab prophylaxis in the COVID-19 era
Richard S. Taylor
CMAJ Apr 2021, 193 (15) E523; DOI: 10.1503/cmaj.78240
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Possible resurgence du virus respiratoire syncytial au Canada
  • Potential resurgence of respiratory syncytial virus in Canada
  • Google Scholar

More in this TOC Section

  • The 5 Ps need an update: toward a comprehensive sexual history
  • Don’t ignore perimenopause
  • Hospital-at-home programs in Canada: challenges and pitfalls
Show more Letters

Similar Articles

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected]

CMA Civility, Accessibility, Privacy

 

Powered by HighWire