RSV vaccine used in 40 other countries could save babies' lives
More modern vaccines for pregnant women and babies are available overseas.
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A vaccine available in about 40 other countries could cut hospitalisation of babies with a potentially deadly lung infection by 80 percent, according to child health experts.
New Zealand has the world's highest rates of serious illness caused by Respiratory Syncytial Virus (RSV), with 2000 children under five admitted to hospital each year, due to complications from the virus.
Early childhood teacher Kerri had an outbreak at her Auckland centre last month, which turned out to be RSV.
"It went very quickly from coughing on and off to a really big cough in a short space of time," she said. "Some of them started coughing so hard, they actually vomited, so once that happened, we started sending children home."
Not everyone was tested, but Kerri estimated 8-10 children fell sick and the sibling of one child had to be hospitalised. She was already on high alert, after a previous experience with RSV.
"One child, I remember, they developed it and they ended up in hospital in an induced coma, and that was really scary. I didn't realise how bad it was, until that case."
Starship Hospital paediatrician Cameron Grant said rates were even higher for Māori and Pacific children, with three and four times more likely than Pakeha babies to be hospitalised, along with those living in poorer households.
"Pneumonia and bronchiolitis, which are the most common infections it causes, are roughly twice those of England and the United States."
As of 1 January, only one vaccine (Palivizumab) is funded in New Zealand for a very small number of high-risk babies - those who are extremely premature or have other serious health problems. It needs to be given as an intramuscular injection every month, which presents its own logistical difficulties.
Grant, who is also professor of child health at Auckland University, said more modern vaccines for both pregnant women and babies provided protection for at least six months, but these were not available in New Zealand.
"It's now more than 40 other countries around the world are using these, including Australia.
"All we have is a product that was developed 25 years ago, which involves an intramuscular injection each month, and the only reason we've got it here is because all these other countries are buying these newer products, which are better."
Infectious disease expert Elizabeth Wilson said RSV vaccination was now offered to every baby in the United States before winter.
"It's hugely effective. There's data coming out from various places - Paris, Galicia, the States, Western Australia - and all are showing well into the 80 percent protection, certainly against hospital admission with RSV."
The other group at risk of serious illness from RSV is the elderly.
The vaccine Arexvy is approved for use in New Zealand for those aged 60 and older, but that is not funded and costs $475.
However, there was nothing for pregnant women or children, even if families were prepared to pay for it, Wilson said.
Both doctors were disappointed that Pharmac had no plans to fund a vaccine to protect babies, despite their advocacy.
"We've had no indication that it's going to happen in the near future," Wilson said.
Professor Grant was blunt in his assessment of the lack of action: "We don't value child health in New Zealand as much as any of these other countries."
The vaccines would save the health system money by reducing serious illness and hospitalisations, he said.
"More importantly, they could save lives".
Pharmac director for advice and assessment Dr David Hughes said the agency had not received a funding application for an RSV vaccine for young people or pregnant people, nor for a new preventative treatment for young people at risk from RSV infection.
"We have been talking with the suppliers of these vaccines and preventative treatments to understand their interest in submitting funding applications," he said.
In assessing applications, Pharmac had to consider a number of factors, "including the costs and potential savings to the health system", while suppliers also needed to apply to Medsafe for regulatory approval.
Pharmac did receive a funding application for the Arexvy vaccine for adults aged 60 and older in January last year, but that application remained "on hold, until further information can be provided".
"There are always more medicines we would like to fund and while some are medicines available in other countries, our funding and reimbursement systems are often not comparable," Hughes said. "We need to make our own decisions about what to fund and for who in New Zealand."
While Pharmac determined which vaccines ere funded and the eligibility criteria, Health NZ | Te Whatu Ora was responsible for actually delivering those vaccines.
The health official in charge of immunisation programmes, Jolene Proffit from the National Public Health Service, said Abrysvo (the vaccine for pregnant women) was "not currently approved for use in New Zealand".
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