2023-10-26 05:26:46
Faced with the high demand for Beyfortus, maternity hospitals must administer the treatment to the most fragile infants. The president of the French Association of Ambulatory Pediatrics details these “overprioritization” rules for Libération.
Bronchiolitis affects nearly one in three infants each winter. This year a preventive treatment once morest respiratory syncytial virus (RSV) was offered to parents: Beyfortus. Problem, while Ile-de-France, Brittany, Pays de la Loire, Guadeloupe, Martinique or Guyana have entered the “epidemic phase”, the doses of this monoclonal antibody are running out of demand. growing parenthood. Initially accessible in pharmacies upon presentation of a prescription and in hospital maternity wards, the Ministry of Health restricted access to the treatment to maternity wards only on September 27. A month later, France Inter revealed that in maternity wards, caregivers had to sort infants to administer doses. At the Châteaubriant-Nozay-Pouancé hospital center (Maine-et-Loire), the pediatrics department “navigates on sight in the administration of its doses” and has therefore decided to reserve the treatment for children at risk. For Libération, Andréas Werner, president of the French Association of Ambulatory Pediatrics (Afpa) and pediatrician, details the causes of the “overprioritization” of this treatment once morest bronchiolitis.
How to explain this shortage of doses of Beyfortus?
While it is important to remember that epidemics, such as that of bronchiolitis, start earlier and earlier and last longer and longer, the Ministry of Health ordered doses of Beyfortus between May and June. It was then necessary to estimate the quantity of doses needed for the winter. For this, we rely on an indicator, the rate of parental adherence to other vaccines or treatments for children. The choice fell on the treatment for gastroenteritis for which parental support was around 20-30%. 200,000 orders were therefore made in the spring but today 500,000 would be needed to meet parental demand…
The State currently has 38,000 doses in its reserves, all in small dosages (50 mg) and it still has around 10,000 doses in 10 mg. At a meeting on Wednesday, October 25 in the morning with representatives of the Ministry of Health, the various pediatric associations were kept informed of the situation. Other deliveries are underway. Additional doses, ordered from laboratories, should be delivered during the month of November. It’s rather reassuring. The peak of the epidemic will arrive in December and the worst thing would be to be unable to protect children at that time. Which should not happen between redelivery and “overprioritization”.
Does this “overprioritization” not reflect an emergency situation?
This term illustrates a particular situation and a primordial reaction. Afpa, the French Society of Pediatrics and the French Society of Neonatology were consulted to develop these measures to protect babies most at risk. First of all, these are premature babies and very low birth weight infants, who weigh less than 2.5 kilos. There also remain children with neonatal pathologies. We also chose to count babies whose siblings are often in public places. If the child is the fourth of a family and the other three go to kindergarten, he is a child at risk.
There are also financial reasons to consider. Certain socio-economic situations do not allow parents to take distancing or social protection measures. In families where both parents return to work very soon following the birth of the child and for whom home care cannot be set up, the baby ends up in daycare where he can contaminate and be contaminated more easily. There, he is another child at risk to be protected. Of course, if you are a firstborn who stays at home for six months or more, you still have a much lower chance of catching the virus.
What should we say to families whose children cannot benefit from treatment?
When we explain to them that their child is much less at risk than others and that a choice must be made, they understand it quite well. These families must also apply all the social distancing measures that we learned during the two years of Covid. Do not bring your baby to supermarkets. To protect them, you must wear a mask if the parent is sick. You must ventilate the rooms well and disinfect your hands. You have to remember that during Covid we had almost no more bronchiolitis. Let us also remember that 200,000 babies will be protected. Compared to other large European countries where there is zero immunization, the general circulation of RSV will be significantly less. There is indirect protection. In addition, we are at the start of the epidemic and at the moment it is not bronchiolitis due to RSV (which Beyfortus acts once morest) which is the strongest. At the start of the season, bronchiolitis caused by rhinoviruses infects children. In the middle of the epidemic, around December, 90% of infections are attributable to RSV and at the end of the epidemic it is the influenza virus which becomes the main cause of bronchiolitis. To protect your children once morest these late-onset bronchiolitis, you can always vaccinate babies and those around them once morest these viruses.
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