Respiratory syncytial viruses (RSV) are the most common cause of hospitalization in newborns and infants during the winter period. From autumn 2024, the monoclonal antibody nirsevimab (Beyfortus®) will be available for basic immunization. In the Department of Obstetrics and the Department of Neonatology at the USZ, an interprofessional concept ensures that as many newborn children as possible benefit from this protection against RSV. Ladina Vonzun, Head Physician at the Obstetrics Clinic, explains the process.
Respiratory syncytial viruses (RSV) cause colds, flu-like illnesses and bronchiolitis, especially in the winter months. During this time, RSV is the most common cause of hospitalization in newborns and infants. The monoclonal antibody nirsevimab (Beyfortus®) will now be available from fall 2024. This is recommended by the Federal Office of Public Health (FOPH) and the Federal Commission for Vaccination Issues (EKIF) as a basic immunization for all newborns born between October and March, in the first week of life or as soon as possible thereafter. “It is important to note that this is not a vaccination, but a passive immunization. The administration of antibodies (IgG) provides the newborn with direct immune protection,” emphasizes Ladina Vonzun, Head Physician at the Department of Obstetrics at the USZ.
Immunization against RSV – an interprofessional concern
The efficacy of nirsevimab has been investigated and proven in several international studies, and its safety and possible side effects were observed in studies involving 3751 children over a period of one year. In addition, nirsevimab has already been administered to tens of thousands of newborns and infants in several countries in the winter half-year 2023/2024. Payment is covered by compulsory health insurance. The costs of the medication are included in the SwissDRG, but not the additional nursing and medical services. This forces hospitals to keep the additional costs associated with the administration of Nirsevimab in the inpatient setting as low as possible, while at the same time aiming to achieve an optimal level of immunization coverage for newborns. The latter requires the parents to be well informed in advance in the outpatient setting by the practicing gynecologists and midwives, as well as optimal interprofessional cooperation. “At the USZ, we have developed an RSV immunization concept in collaboration between the obstetrics and neonatology clinics, which uses the various contact points during pregnancy, immediately after birth and in the postpartum period to raise awareness and inform parents-to-be about immunization – and thus immunize as many newborns as possible and discharge them home already protected,” says Vonzun.
Information for parents at several contact points
According to the SGGG newsletter, expectant parents are informed by gynaecologists and midwives about the possibility of RSV immunization during the puerperium during pregnancy check-ups in the outpatient area and on the prenatal ward, and they also receive information on this with the birth documents, which are also available during consultation hours and are included in the eMaternity record.
During the newborn status in the delivery room (e.g. after administration of vitamin K), parents are again reminded that passive immunization against RSV is still recommended during hospitalization in the puerperium. The medical team, midwives and nursing staff on the maternity ward will continuously clarify any questions parents may have. The check-up by the neonatologists offers another opportunity for this. If the parents have opted for immunization, it will be administered by the nursing staff on the maternity ward following a written prescription and documented in the vaccination record.
“A central element of the concept is the repetition of the topic at different times by different professions. In this way, the topic remains present, but we also show that all professional groups support immunization,” says Ladina Vonzun, summarizing the basic idea behind the concept. “The referring gynecologists and midwives are therefore important partners.” Another important aspect is to always actively communicate to parents that doctors, midwives and nursing staff are always open to questions about immunization and are happy to discuss these with them. “We hope to reach as many parents as possible who may still be unsure and provide them with the information they need to make a decision.”
More information about the RSV
