RSV Immunisation Pathfinder Programme

The Minister for Health recently announced an infant Respiratory Syncytial Virus (RSV) Immunisation Pathfinder Programme will be implemented by HSE for all newborn infants during the coming RSV season (from September 1 2024 to February 2025), with the administration of a new long-acting RSV monoclonal antibody — Nirsevimab ( Beyfortus). Nirsevimab will also be administered to those high-risk babies who are currently eligible for Palivizumab (Synagis). The switch over as recommended by NIAC will happen from the start of the pathfinder programme on 1 September 2024.

Nirsevimab will be given to all newborn babies this RSV season before they are discharged home from the maternity hospital to protect them in the first days and weeks of life, when the risk of RSV infection with serious outcomes is at its greatest. One dose of Nirsevimab will provide protection to the infant for 150 days, the entire RSV season. Nirsevimab is administered as an intramuscular injection and can be given from birth.

As Nirsevimab is a passive antibody immunisation, it does not require the infant to generate its own antibodies using its own immune system, nor does it interfere with the infants’ immune response to vaccines in the current immunisation schedule. Therefore, Nirsevimab can be co-administered with any Primary Childhood immunisation. Newborn babies who receive Nirsevimab from hospitals soon after birth can commence the normal course of vaccinations that start at 2 months of age.

As part of the RSV Pathfinder Programme, pregnant women will be provided with written and verbal information on the RSV immunisation programme at their antenatal clinics and soon after birth of their baby.

A Pathfinder Programme refers to a strategic initiative designed to explore innovative approaches to improving health outcomes within a community or population. These programmes often serve as pilots or models that, if successful, can be scaled up and replicated in other settings.

HIQA health technology assessment

On 14 August HIQA published their rapid assessment of immunisation against respiratory syncytial virus (RSV) in Ireland. The assessment noted the following:

• The estimated one-year cost of immunising infants for their first RSV season ranged from €3.9 to €19 million depending on the strategy used and would be partially offset by fewer hospitalisations;
• The estimated one-year cost of immunising everyone aged 65 years and older was €146 million, or over €76 million if only offered to those aged 75 years and older. As the number of older people who are hospitalised due to RSV is relatively small, the potential cost savings to the HSE from reducing hospital admissions is also small (between €0.9 million and €1.2 million); and
• Data collection will be important to support the ongoing evaluation of the effectiveness of any programme that is implemented.

This rapid HTA has been submitted as advice to the Minister for Health and the HSE to inform an interim policy decision on the most appropriate RSV immunisation strategy for the 2025 – 2026 RSV season.

HIQA will now conduct a larger assessment to provide advice to inform a longer-term policy decision on RSV immunisation. This will include emerging international evidence, and experience from the HSE’s RSV Immunisation Pathfinder Programme, which is being piloted for the 2024 – 2025 RSV season. For further information go to hiqa.ie http://hiqa.ie/> Reports and Publications > Health Technology Assessments.