Letters to the Editor Re: Robinson JL, Le Saux N. Preventing Hospitalizations for Respiratory Syncytial Virus (RSV) Infection. Canadian Paediatric Society Infectious Diseases and Immunization Committee. Paediatr Child Health 2015;20(6):321-33.
To the Editor; We are a group of paediatricians who wish to express major concerns about this particular Position Statement, published in the August/September 2015 issue of the Journal, and its implications for children and families within our community. Several of the quotes are incorrect, which reflects an incomplete search of the relevant scientific literature. In the United States outcomes registry (2000-2001), 75% of all RSV-related hospitalizations (RSVH) occurred between the first and second injection intervals (1), and the highest RSVH percentage (31%) was also noted in the same time interval in 2000-2004 (2). Palivizumab does prevent intensive care unit admissions, and the Cochrane metaanalysis (n=2789) confirms the same (RR 0.50 [95% CI 0.30 to 0.81]) (3). In a randomized trial, palivizumab recipients also had a statistically lower incidence of medically attended, non-hospitalized RSV infection, suggesting an attenuated effect on disease severity (4). The recommendation for three to five doses is based on low-quality evidence through observational studies without palivizumab levels (5,6). Reports confirm that after three doses, 52% and 85% of infants have palivizumab levels