Mother, doctors call on N.L. government to expand coverage of RSV shots to all infants

When Michelle Pratt’s twin sons were born prematurely at 32 weeks and four days, she was eager to make sure they wouldn't get sick — including from respiratory syncytial virus, or RSV.

RSV is a common, highly-contagious virus that causes infections of the respiratory tract. It can quickly become dangerous for infants, leading to hospitalization and — in rare cases — death.

"As a parent, you want to do everything you can to protect your children," said Pratt.

"Just last year, we had two close friends and their children [who] were hospitalized for RSV. So, it's a very common occurrence."

Pratt is a dermatologist in St. John’s. She did a deep dive into medical research during her pregnancy, looking at guidance from national expert groups, such as the Canadian Pediatric Society, as well as the National Advisory Committee on Immunization (NACI).

"They all have the same message — that they recommend nirsevimab as first-line prevention for severe RSV for newborn babies and young infants," she said.

Nirsevimab is a monoclonal antibody, also known by its brand name Beyfortus. It was approved by Health Canada in April 2023 and recommended for all infants in their first RSV season. The single-dose drug is given to infants shortly after birth and provides protection for about five months.

Less than a year later, the department also approved a new bivalent vaccine, called Abrysvo, which is given to pregnant people between 32 and 36 weeks of gestation to protect the baby for the first six months after birth.

In 2024, NACI, which advises the federal government, recommended that provinces work "towards a universal RSV immunization program for all infants."

Most provinces have followed that recommendation, offering coverage of nirsevimab to varying degrees.

Only four provinces — Newfoundland and Labrador, Alberta, British Columbia and New Brunswick — reserve coverage for high-risk infants.

According to the provincial Department of Health, that group includes children under the age of two with chronic lung or congenital heart disease, and premature babies born "at less than or equal to 30 weeks."

That criteria excluded Pratt’s sons, who were born a little over two weeks past the cut off.

"When they're born that early, you just don't know what way things are going to go. So, it was a very stressful time," said Pratt.