Summary

Unequal impact of respiratory syncytial virus immunization in patients attending Spanish pediatric emergency departments

David Andina Martínez1, Clara Barrueco Ramos2, Silvia Escalada Pellitero3, Adrián Ranera Málaga4, José Lorenzo Guerra Díez5, Verónica Gimeno-Hernández Garza6, Nerea González Arza7, Juan Ventura Pernia8, Victoria Sánchez Tatay9, Clara Ferrero García-Loygorri10, Begoña de Miguel Lavisier11, Laura Baños López12, Amaia Cámara Otegui13, Manuel Gijón Mediavilla14, Gemma Claret Teruel15, José Antonio Alonso-Cadenas1, en representación del Grupo de Trabajo sobre el Impacto de la profilaxis universal del Virus Respiratorio Sincitial en España

Affiliation of the authors

1Servicio de Urgencias Pediátricas, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. Instituto de Investigación Sanitaria Hospital Universitario La Princesa, Madrid, Spain. 2Servicio de Urgencias Pediátricas, Complexo Hospitalario Universitario de A Coruña, A Coruña, Spain. 3Servicio de Urgencias Pediátricas, Hospital Universitario de Canarias. Tenerife, Spain. 4Servicio de Urgencias Pediátricas, Corporacio Sanitaria Parc Tauli. Institut d’Investigació e innovacio. I3PT. Sabadell, Barcelona, Spain. 5Servicio de Urgencias Pediátricas, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 6Servicio de Urgencias Pediátricas, Hospital Universitario Miguel Servet de Zaragoza, Zaragoza, Spain. 7Servicio de Urgencias Pediátricas, Hospital Universitario de Navarra, Pamplona, Spain. 8Servicio Urgencias Pediátricas, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain. 9Servicio de Urgencias Pediátricas, Hospital Universitario Virgen del Rocío, Sevilla, Spain. 10Servicio de Urgencias Pediátricas, Hospital Universitario Gregorio Marañón, Madrid, Spain. 11Servicio de Urgencias Pediátricas, Hospital Universitario La Paz, Madrid, Spain. 12Servicio de Urgencias Pediátricas, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. 13Servicio de Urgencias Pediátricas, Hospital Universitario Donostia; Instituto de Investigación Sanitaria Biogipuzkoa, San Sebastián, Spain. Universidad del País Vasco, UPV-EHU, San Sebastián, Spain. 14Servicio de Urgencias Pediátricas, Hospital Universitario Doce de Octubre, Madrid, Spain. 15Servicio de Urgencias Pediátricas, Hospital Sant Joan de Déu. Barcelona, Spain. Universidad de Barcelona, Barcelona, Spain. Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain.

DOI

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Andina Martínez D, Barrueco Ramos C, Escalada Pellitero S, Ranera Málaga A, Guerra Díez JL, Gimeno-Hernández Garza V, et al. Unequal impact of respiratory syncytial virus immunization in patients attending Spanish pediatric emergency departments. Emergencias. 2025;37:360-6

Summary

Objectives.

To evaluate the impact of respiratory syncytial virus (RSV) prophylaxis with nirsevimab during its 2nd year of administration and analyze the differences between the different strategies implemented across Spanish autonomous communities (ACs) during the current epidemic season.

Methods.

We conducted a retrospective analytical study with 15 pediatric emergency departments across 9 ACs. We included all infants younger than 6 months who were treated in November, December, and January during 5 epidemic seasons (2018–2019, 2019–2020, 2022–2023, 2023–2024, and 2024–2025).

Results.

Compared with the average of epidemic seasons prior to the introduction of nirsevimab, in 2024–2025 there was a 65.5% decrease in episodes of acute bronchiolitis (95% CI, 64.3–63.7; P < .001). Hospital admissions for bronchiolitis decreased by 74.7% (95% CI, 72.7–76.6; P < .001), and PICU admissions fell by 72.9% (95% CI, 68.1–77.2; P < .001). The reductions achieved in the 2024–2025 season were greater than those observed in the 2023–2024 season. The hospital from the AC that decided not to immunize infants born before the start of the epidemic had the worst outcomes. Among the ACs that applied the same strategy, worse outcomes were observed in the one that immunized out-of-season infants through selected hospitals rather than primary care centers.

Conclusions.

Nirsevimab prophylaxis in Spain during the 2024–2025 season provided even greater protection vs RSV infection in infants younger than 6 months. However, differences across ACs were observed, likely related to the specific immunization strategies implemented.

 

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