After a particularly early, long and intense 2022-2023 bronchiolitis epidemic, health authorities are banking on “treatment and simple actions” to limit cases but also the pressure that this disease places on the healthcare system each winter. As the Ministry of Health and Prevention explained during a press briefing, barrier gestures (hand washing and wearing a mask in the event of symptoms in those around you, avoidance of crowded areas, etc.) .) remain crucial to protect toddlers. But this year, for the first time, young parents have available preventative treatment against one of the main viruses responsible for bronchiolitis. France is among the few countries that will be able to benefit from nirsevimab (sold under the name Beyfortus) this year. Two hundred thousand doses have been reserved by Public Health France (SPF) with the manufacturer Sanofi to cover the epidemic period.
Monitoring carried out year after year by Public Health France (SPF) shows that bronchiolitis epidemics have long been almost flawlessly reproducible. They started in November, peaked in December and ended at the end of January. But since Covid has been circulating and barrier gestures have disappeared, the profile of the epidemic has changed. In 2021, the onset and peak of the epidemic were early, with an intensity similar to that of epidemics before the pandemic. The winter of 2022-2023 was marked by a “triple epidemic” resulting from the simultaneous circulation of the influenza virus, Sars-CoV-2 and the respiratory syncytial virus (RSV), responsible for 80% of cases of bronchiolitis. An unprecedented situation which had strained hospital resources.
For the moment the epidemic has not yet officially started but Public Health France noted during the week of September 4, marked by the start of the school year, a 28% increase in hospitalizations for bronchiolitis. A signal which could augur a “situation similar to that of last year” and should lead to “caution”, believes SPF. The campaign to immunize newborns with nirsevimab was therefore officially launched by the Minister of Health, Aurélien Rousseau, on September 15.
Nirsevimab is not a vaccine but a preventive treatment. “While the vaccine teaches the immune system to produce antibodies, this treatment directly provides the infant with antibodies to prevent RSV from entering cells and therefore triggering an infection,” detailed Professor Christèle Gras-Le Guen, head of the pediatric department at Nantes University Hospital and charged by the government with supporting this immunization campaign. RSV is a dangerous virus mainly for toddlers: each year, around 30% of those under the age of two are infected, or 480,000 children. “Hospitalizations mainly concern infants less than one month old,” insisted Professor Gras-Le Guen.
To best protect this particularly vulnerable population, maternity wards have priority in access to doses of nirsevimab and immunization has been offered there since September 15 before returning home. According to the Ministry of Health, the first feedback from the field indicates “good acceptance” on the part of parents. Nirsevimab is also available for all infants born after February 6, 2023, “considered not exposed to RSV during the previous epidemic season”.
Parents who wish to have their child immunized will need to obtain a prescription from their GP and then go to a pharmacy to order the treatment. The pharmacies do not have stock but the product should be delivered to them in “3 to 5 days” according to the Ministry of Health. Parents can then have the injection carried out by one of the healthcare professionals authorized to perform vaccination (nurse, midwife, doctor, etc.). The number of doses available will be limited this year to 200,000, or around 30% of the children concerned, which should correspond to the proportion of parents interested in the treatment, according to the Ministry of Health. The authorities believe that if doses were to run out, “we could not speak of a shortage, but rather of a great success for this first immunization campaign”..
Nirsevimab is made available free of charge, as part of a contract between Public Health France and Sanofi, the amount of which the Ministry of Health has not revealed in the name of “industrial and commercial secrecy”. The unit price of the treatment should be definitively set in the coming months, after negotiations between the Economic Committee for Health Products and Sanofi. Although no range has been communicated, we already know that there will be a basis for reimbursement since the Transparency Commission of the High Authority for Health issued a positive opinion this summer. In the United States, the price of one dose of Beyfortus is $495.