New RSV shot not available to Alberta newborns as virus season ramps up

Some Alberta doctors are calling on the provincial government to make an injection designed to protect newborns from severe RSV available for free to all babies.

Nirsevimab, a monoclonal antibody product, was approved by Health Canada last year.

The shot contains lab-made proteins that act like those created by the body's own immune system. While it is administered prior to exposure, it is not a vaccine.

Ontario and Quebec recently announced the launch of full-fledged provincially funded programs for infants. Nunavut, the Northwest Territories and Yukon are also offering coverage.

But the preventative medication, which goes by the brand name Beyfortus, is not yet available in Alberta.

"Here in Alberta I feel like we are at a disadvantage compared to other provinces," said Dr. Fiona Mattatall, a Calgary-based obstetrician.

She'd like to see the provincial government provide the shot — for free — to all newborns. 

"We have heard nothing from the Ministry of Health or public health to help us know what to do as obstetricians in guiding our patients in this RSV season."

In response to an inquiry from CBC News, Alberta Health confirmed the injections are not available to Alberta newborns.

"For the 2024-25 season, AHS is continuing to work to secure nirsevimab (Beyfortus) for Alberta infants, but the manufacturer has been unable to guarantee supply," a spokesperson said in an email.

The statement did not say how many doses the province is trying to obtain or whether universal coverage would be offered to infants. The new shot is not available for purchase on the private market, according to the province.

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Other options

Health Canada also recently approved Abrysvo, a vaccine given during pregnancies to pass along RSV immunity to newborns. 

And while there is supply through pharmacies, pregnant Albertans have to pay out of pocket for the vaccine. Mattatal would like to see free, universal coverage for Abrysvo as another option for patients.

Alberta is continuing to provide an older monoclonal antibody shot to some high-risk babies, which is administered once a month for the duration of the RSV season.

The National Advisory Committee on Immunization (NACI) issued new guidance earlier this year, suggesting provinces move toward universal immunization of all infants to protect against RSV and recommending nirsevimab over both the other options.

"It's very effective at preventing hospitalization from RSV among young babies, who are those that we really want to protect," said Dr. Eliana Castillo, a Calgary-based physician who specializes in reproductive infectious diseases and cares for patients with high-risk pregnancies.

"I think it's very sad ... It's an unfortunate situation for families who are having a baby — or have had a baby during the season — not to be able to access nirsevimab when we know that it has been possible for other Canadian provinces." 

According to Castillo, Alberta emergency rooms saw an influx of very sick children two years ago during a particularly bad RSV season. She too is calling on the Alberta government to make the new injection available and to pay for it.

While premature babies and those with specific health conditions are at higher risk, RSV can also affect healthy infants, according to Castillo.

"This is a problem for all babies. And, unfortunately, it is a rare event but it is possible that sometimes those babies die from this infection." 

According to NACI, respiratory syncytial virus is the most common cause of bronchiolitis and pneumonia in babies and young children.

And it can lead to serious illness, resulting in hospitalization and ICU admission.

"The kids who are most at risk are those who are born premature or those kids who are basically under six to eight months of age," said Dr. Sam Wong, president of the Alberta Medical Association section of pediatrics and medical director for the Canadian Pediatric Society.

"In the majority of cases they're fine, but a small subset of the population can develop difficulty breathing, fast respirations, they look like they're working really hard to breathe and they may need oxygen as well."

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While NACI recommends building toward universal coverage for all infants, it says if access, cost or affordability are a barrier, rollout could be staged, with those at highest risk prioritized for nirsevimab coverage to start.

Sanofi, the company that manufactures the antibody shot, said it continues to work with all provinces to facilitate access to the medication for all infants.

According to Wong, Canada has a patchwork of implementation which leads to confusion for both parents and health care providers. 

"The problem is the price," he said, adding each shot costs just under $1,000 and essentially lasts one RSV season.

He expects the price will come down in the next year or two.

"Definitely high-risk infants should be getting this particular medicine. Whether your regular newborn should get  it — you can debate the cost effectiveness of it. But I do think we would probably move toward that."