Hi Everyone,
Just a quick update and notes from the recent Webinar in regard to the Qld RSV immunisation program.
Hospital based program has commenced. As of April 15th 2024, all infants born on after the 1st February 2024 are eligible in hospital.
Primary Care based program commences Monday 29th April and providers can order from the 22nd April through QHIP.
Nirsevimab (Beyfortis)
Human recombinant immunoglobulin G1 Kappa monoclonal antibody
RSV F protein-directed fusion inhibitors that bind to the fusion protein on the virus surface
“Passive immunity” provides protection for 5 months.
Effectiveness
European winter – 70-80% reduction in RSV lower respiratory tract infection through to 150 days
Risk Classification
Primary care eligibility;
- Infants born from the 1st Feb, who have not been immunised in hospital, up to less than 8 months of age.
- All Aboriginal and Torres Strait Islander infants (regardless of when they were born) – up to less than 8 months of age.
- Infants up to less than 8 months of age with certain complex medical conditions*.
There is also a time limited catch-up program for young children with certain complex medical conditions*. Infants meeting the clinical criteria can receive Nirsevimab from 8mths until less than 20mths of age, up until October 31st 2024.
A Queensland infant or young child is not required to be Medicare eligible to receive Nirsevimab under this program. ** Please see below for eligibility criteria for Complex Medical Conditions **
Administration:
IM administration into the anterolateral thigh
If more than 2 doses are required at the same time, use different limbs or separate injections site on the same limbs, separated by 2.5cm
Can be safely given with other childhood immunisations.
** See below for Dosage table by Age/Weight**
There is limited stock and some product Alerts to be aware of:
- Please note there is a typo error on the 50mg/0.5ml syringe. The total volume has been printed as 1ml rather than 0.5ml on the carton face. There are numerous locations with the correct 50mg in 0.5ml. There is only one location with the printed error.
- The 100mg dose product comes with German packaging, printed in German and there has been an expiry date extension that has been TGA approved.
- There is an information leaflet in English, which should not be discarded
- The current printed expiry is 04-2024; TGA has granted an extension until the 31st October 2024.
- Staff should record the updated expiry date on the administration record
- This stock should only be used for the older age groups, dose 200mg.
Safety
Serious side effects have not been observed
Mild side effects – soreness, redness, swelling, fever, rash
Possible anaphylaxis
Precaution
Contraindicated if any known allergy to components
Store between 2-8 degrees
There is no private stock, only available through the QHIP. There are stock constraints and as such there are special stock order forms.
Resources
Detailed information on the program here:
Clinical Guidance for Immunisation Providers
QHIP Special Order Form
https://www.health.qld.gov.au/__data/assets/pdf_file/0029/1324955/nirsevimab-special-order-form.pdf
Consent Form
Factsheet for Parents and Carers
First Nations Factsheet for Parents and Carers
https://www.health.qld.gov.au/__data/assets/pdf_file/0022/1324804/rsv-imm-parents-carers.pdf
ATAGI statement on Nirsevimab 2024
https://www.health.gov.au/resources/publications/atagi-statement-on-nirsevimab-2024?language=en
Toolkit available for Community Service Providers. This includes factsheets, social media banners/infographics, posters for your practice etc
Updates to Redbooks will happen later this year.
The Australian Immunisation Handbook is expected to be updated 1 May 2024
*Infants and young children with any of the following complex medical conditions listed below are eligible for nirsevimab.
- Prematurity (infants born less than 32 weeks gestation AND less than 12 months of age).
- Chronic neonatal lung disease (neonates requiring home oxygen/other respiratory support) less than 20 months of age.
- Infants less than 20 months of age with significant respiratory conditions requiring respiratory support such as tracheostomy, non-invasive ventilation (BIPAP or CPAP) or cystic fibrosis with severe lung disease or weight for length less than 10th percentile.
- Infants with haemodynamically significant congenital heart disease, less than 20 months of age.
- Severe primary immunodeficiency# less than 20 months of age AND not yet received curative treatment.
- Trisomy 21, less than 20 months of age.
- Infants less than 20 months of age post solid-organ transplant or end stage organ disease, awaiting transplant.
- Infants less than 20 months of age AND currently receiving active chemotherapy.
- Infants less than 20 months of age within 28 days prior to HSCT or prior to engraftment post HSCT.
- Infants less than 20 months of age with neuromuscular disorders and associated with significantly impaired respiratory function such as spinal muscular atrophy (SMA).
- Other**
#At the clinical discretion of a Paediatric Immunologist
**Case-by-case discussion with a Paediatric Infectious
