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Handkerchiefs and runny noses… Autumn and winter are periods conducive to colds of all types. And to the circulation of RSV, the respiratory syncytial virus. This can lead to illnesses such as pneumonia and, especially in our children, bronchiolitis. The latter is an acute viral infection of the lower respiratory tract, which affects the small bronchi of infants and young children. It mainly affects children under two years of age and manifests itself in the form of seasonal epidemics, generally between autumn and winter. This is a very common viral infection: almost all children catch it once before the age of 2.
It affects approximately 30% of infants each year. Vulnerable children, such as premature babies, those with low birth weight, babies less than six weeks old, or those with respiratory abnormalities, cardiac or neurological diseases or immunodeficiency are particularly at risk. Infants exposed to passive smoking or other environmental factors such as community care, living in an urban area, or poor socioeconomic conditions are also more likely to experience relapses.
2,500 children under the age of two hospitalized per year
In Belgium, each year, around 2,500 children under the age of two are hospitalized due to bronchiolitis. A significant percentage of these children require intensive care support. Fortunately, there have been very few deaths. But, every year, healthcare staff are overwhelmed by the influx of young patients into the emergency room. This state of affairs will change. For many years, there have been monoclonal antibodies that could be administered to young children to prevent them from catching this infection. But these antibodies had to be administered in five doses and the cost for one patient was 5,000 euros. Only very high-risk infants received reimbursement. Today, there is a single-dose monoclonal antibody: Beyfortus. It has been accessible since October 3. Its cost is lower. All the same 780 euros. But a refund is given. This amounts to €8 or €12.10 for parents of an infant born from April 1, 2024. Newborns will be offered it from the maternity ward.
We expect, from this year, a reduction in hospitalizations for this disease which should be around 80%. If parents respond, hospitals should see their pediatric departments significantly relieved of congestion this winter, for the benefit of all young patients. The beds freed up, the human resources relieved, the nursing staff more available will allow better management of other pathologies. Welcomed by all pediatric services, the arrival of Beyfortus should also bring social benefits. That of sparing young parents and grandparents the worry, stress and, sometimes, the heartbreak of seeing their baby, in respiratory distress, be hospitalized…
This is not a vaccine
Certain headlines of press articles devoted to Beyfortus suggest that this product is a “vaccine” against bronchiolitis. In reality, talking about a vaccine here is an abuse of language. Beyfortus is a monoclonal antibody treatment. However, a vaccine is by definition the injection of a deactivated or attenuated pathogen allowing the triggering of an immune reaction (i.e. the production of antibodies) within the body. In the case of Beyfortus, this involves directly injecting the antibody which will neutralize the virus. It is help that is provided directly to the infant’s immune system.
Another way to protect the infant against bronchiolitis is to act when it is still in its mother’s womb. Abrysvo allows the future mother to produce antibodies in reaction to the product and to transmit them naturally to her fetus via the placental barrier. This substance produces an immune reaction, so it is a vaccine. Beyfortus and Abrysvo are two different approaches, however based on the same concept of immunization because, in both cases, it is not the infant, whose immune system is immature until 3 months old, which produces its own antibodies. .
Side effects?
In France, the National Medicines Safety Agency has released a preliminary report on the monitoring of adverse effects associated with Beyfortus. “Between September 11, 2023 and April 30, 2024, 244,495 doses of Beyfortus were administered, mainly in maternity hospitals and in the city. During this period, 198 reports of adverse effects were recorded, a relatively modest figure compared to the volume of doses distributed. Of the cases reported, 74.7% involved presumed ineffectiveness of the treatment, with children developing bronchiolitis despite administration of the antibody. The severity of cases varied, but no deaths were recorded, and no specific risk factors could be identified in affected children.” On the other hand, in France, the use of Beyfortus from 2023 has enabled a reduction in hospitalizations among infants ranging between 76% and 81% for cases requiring admission to intensive care.
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