Are the authorities ready for the immunity campaign that begins on September 15?

During the 2023-2024 season, Beyfortus, a preventive treatment used against bronchiolitis, was very quickly reserved for maternity wards, due to a lack of available doses. This year, nearly 600,000 doses have been ordered and a new vaccine will also be offered to pregnant women.

The campaign to immunize infants with nirsevimab, a treatment marketed under the brand name Beyfortus and intended to limit the risks of bronchiolitis in babies, begins on Sunday, September 15. To do this, some 600,000 doses were ordered at the end of August to supply French pharmacies, according to figures of the pharmaceutical group Sanofi. “The product is already available in pharmacies and will arrive at the hospital in mid-September”greets Christèle Gras-Le Guen, spokesperson for the French Pediatric Society.

This treatment is highly anticipated by pediatricians and families. Administered to toddlers from the maternity ward, it is effective from five to seven months. It has also prevented “approximately 5,800 hospitalizations for bronchiolitis after going to the emergency room” between September 15, 2023 and January 31, 2024 in mainland France, according to two studies conducted by Public Health France and the Pasteur Institute. “This is linked to the particularity of this immunization, which consists of injecting antibodies which will prevent the virus from blocking itself in the bronchi and from replicating.”explains Philippe Babe, head of the pediatrics department at Lenval hospital in Nice.

Nearly 600,000 doses, that’s almost three times more doses than last season, when with only 200,000 doses, the molecule could not be administered to all infants. A victim of its success, the treatment had been reserved for maternity wards from September 2023. “Last year was a trial run, to our credit, because we were the only country in the world to have launched a trial of this magnitude”underlines Christèle Gras-Le Guen, who is also head of the “women-children-adolescents” unit at the Nantes University Hospital.

With the number of doses planned this year, the vast majority of newborns will be able to receive their treatment: since January 2024, the number of births has been constantly decreasing compared to 2023, when 678,000 babies were born, according to INSEE. “A priori, everything is okassures franceinfo the president of the Union of Pharmacists’ Unions, Pierre-Olivier Variot. This is not a medicine that we have in stock, we will order it as and when prescriptions are filled. We have been assured that the wholesalers will be supplied.”

Since August, Beyfortus is no longer the only treatment available to prevent bronchiolitis, this disease caused by a respiratory syncytial virus (RSV), most often benign, but which sometimes presents severe forms and can require hospitalization. Administered to a pregnant woman during the eighth month of pregnancy, the Abrysvo vaccine, covered by health insurance, allows antibodies to be transmitted to the future baby up to 6 months thanks to the transfer of maternal antibodies. “We hope that with the vaccine and treatment, we will be able to reduce the severity of the disease and the number of cases.”notes Christèle Gras-Le Guen. But on this point, Andreas Werner, president of the French Association of Ambulatory Pediatrics (Afpa), is more sceptical: “When we see that vaccination coverage for influenza is only 5 or 10%, it is unlikely that there will be good vaccination coverage with a new vaccine.”

The challenge of this dual campaign is to avoid reliving the 2022-2023 season, during which hospitals were saturated in the face of a triple epidemic of flu, Covid-19 and bronchiolitis, with a total of 73,262 children under 2 years old admitted to emergency services between November 2022 and January 2023, “which is almost twice the value average epidemics” recorded between 2015 and 2020, noted Public Health France at the time. To the point that thousands of professionals had written to the President of the Republic in The Parisian to alert him about the “glaring deterioration in the care provided to children which puts them[tait alors] “daily in danger”. Several babies even had to be hospitalized far from home, due to lack of space in a closer establishment.

Especially since this injection is not only useful for relieving pressure on hospital services. “Bronchiolitis is above all a burden in terms of consequences on the health of children, particularly in terms of ear infections, pneumonia, and this contributes to the outbreak of infant asthma”recalls Jean-François Pujol, general secretary of the National Union of French Pediatricians.

However, the vaccine and treatment should not make us forget to respect barrier gestures, such as washing our hands and wearing a mask when we are sick. Beyfortus and Abrysvo “only protect against RSV, but not against whooping cough, influenza or winter viruses”recalls Christèle Gras-Le Guen. Before emphasizing: “A toddler should stay safe, avoid large family gatherings, public transport or shopping malls, especially in winter.”