New RSV vaccine for seniors not covered in New Brunswick

New Brunswick's RSV season is underway with 11 confirmed cases so far, but any seniors interested in getting the new vaccine against respiratory syncytial virus will have to pay for it themselves.

Meanwhile, no decision has been made yet on the use of a new antibody injection to protect babies from serious illness caused by the virus.

And there's still no word on whether the province will make RSV a reportable disease, like COVID-19 and the flu.

Last fall and winter, New Brunswick recorded more than 1,500 RSV cases — the highest number in at least a decade.

The Department of Health is aware Health Canada approved Arexvy — the first RSV vaccine for people aged 60 and older — in August, said spokesperson Sean Hatchard.

"However, at this time, New Brunswick will not be providing a publicly funded RSV vaccine," he confirmed in an emailed statement.

Seniors 'really concerned'

That's "not acceptable," according to Cecile Cassista, the executive director of the Coalition for Seniors and Nursing Home Residents' Rights.

She wrote to Health Minister Bruce Fitch, deputy minister Eric Beaulieu and Kathy Bockus, the minister responsible for seniors, last week, calling on the province to fund the vaccine, after hearing from a number of seniors who are "really concerned they can't afford to pay" the estimated $270.

"Let's not wait until this virus takes control like COVID did. This government needs to take the lead," Cassista wrote on Oct. 16.

RSV is a common respiratory virus most children contract by the age of two. It causes a mild cold-like illness for most people but can be severe for people aged 65 and older, infants and people who are immunocompromised, according to Health Canada. It can result in hospitalization and even death.

"This is a highly contagious respiratory disease, and I really think that every step the government [can] take to prevent our aging population from being ill from this is highly important," said Cassista.

As it stands, most provinces are not covering the cost, although Ontario is providing the vaccine free-of-charge in congregate living settings such as long-term care homes.

I think they need to go back to the drawing board and certainly revisit this situation.- Cecile Cassista, Coalition for Seniors and Nursing Home Residents' Rights

Still, Cassista said it's "disheartening" to hear New Brunswick is not going to be more proactive, particularly since it ranks among the best in the country for its influenza vaccine program.

New Brunswick provides a high-dose flu shot, designed to give seniors a stronger immune response, and better protection against the flu, free of charge to those aged 65 or older.

"I think they need to go back to the drawing board and certainly revisit this situation," said Cassista.

At the very least, she argues, the province should cover the cost for seniors with respiratory problems.

Awaiting NACI recommendations

The National Advisory Committee on Immunization, known as NACI, has not yet issued its recommendations for the RSV vaccine, Hatchard, of the Health Department, noted.

"Once we review these recommendations and other information, we will have an opportunity to revisit the decision," he said.

New Brunswick is also awaiting NACI guidance on nirsevimab, a drug approved by Health Canada in April for newborns and infants during their first RSV season, and for children up to two years of age if they are at risk of serious infection.

Nirsevimab, also known by the brand name Beyfortus, is not a vaccine, but is given by one injection.

"At this time, no decision has been made on the use of nirsevimab in New Brunswick," said Hatchard. "NACI guidance for nirsevimab is only expected to be published in August 2024."

New Brunswick does offer palivizumab, another antibody drug injection, also known by the brand name Synagis, to infants at high-risk for RSV infection, based on provincial guidelines and NACI guidance, said Hatchard. NACI does not recommend palivizumab for healthy babies.

Palivizumab has to be injected about once a month — up to four times — during RSV season to remain effective.

Monitoring RSV closely

The Department of Health will be monitoring the RSV situation "closely," said Hatchard.

Infectious disease experts have said the surge in RSV cases last fall and winter was due in part to the lifting of COVID-19 pandemic restrictions, such as masking and distancing, which had prevented infections in the previous years, so many children were exposed to RSV for the first time.

Eleven New Brunswickers have tested positive since the respiratory season began on Aug. 27, including one during the week ending Oct. 7, according to the latest figures posted by the Public Health Agency of Canada.

Ages, hospitalizations, deaths not reported

Nearly a year ago, Dr. Yves Léger, then-acting chief medical officer of health, said Public Health would look "in the near future" into whether RSV should become a reportable disease in the province.

Although RSV is a reportable disease in some other provinces, such as P.E.I., it's not in New Brunswick. That means it's not monitored or communicated to the public in the same way as a reportable disease, such as COVID-19 or the flu, with weekly reports.

The province currently simply inputs RSV test data into the national surveillance system weekly. No information about RSV-related hospitalizations or deaths, or breakdowns by ages are available.

During a November media briefing on RSV, COVID-19 and the flu, and their impact on the hospital system, Léger told reporters, "we'll certainly be looking at that in the near future to see if we should be considering adding that in."

The Department of Health is "in the process of conducting a review" of the Public Health Act and its regulations, according to Hatchard.

He did not respond to questions about when the review began or why it has taken this long.

"We will be able to share details of the review, including any changes to reportable diseases, once it is finalized," he said. He declined to provide an estimate of when that might be.

Symptoms to watch for

In Canada, the RSV season typically begins in October or November and lasts until April or May.

Symptoms often begin two to eight days after exposure to the virus and may include:

• Runny nose.
• Coughing.
• Sneezing.
• Wheezing.
• Fever.
• Decrease in appetite and energy.

In infants, the Public Health Agency of Canada says symptoms may include:

• Irritability.
• Difficulty breathing.
• Decreased appetite or feeding.
• Decreased activity.