The Brazilian Ministry of Health has announced the incorporation of two new technologies aimed at preventing complications caused by the respiratory syncytial virus (RSV), one of the leading causes of severe respiratory infections in infants, including bronchiolitis. The newly incorporated treatments include the monoclonal antibody nirsevimab and the recombinant vaccine targeting RSV types A and B. This initiative seeks to protect premature infants and children with underlying health conditions, alongside providing passive immunity to newborns via maternal vaccination.
The rising concern surrounding bronchiolitis cases, particularly noted this year, has been alarming, especially within the Campinas region. According to data from the State Health Department (SES), there were 36,489 outpatient visits and 22,922 hospitalizations due to bronchiolitis across São Paulo state throughout 2024. Specifically, the regional health department of Campinas recorded 2,788 outpatient visits and 2,066 hospitalizations related to this condition, marking a staggering increase of 32.7% compared to the previous year. The figures from 2023 also indicated the seriousness of the situation, with 2,101 outpatient visits and 2,291 hospitalizations.
Bronchiolitis is defined as a common viral infection affecting infants and young children, characterized by inflammation of the bronchioles, the small air passages within the lungs. It is typically caused by RSV and results in symptoms such as coughing, wheezing, respiratory distress, and fever. Severe cases may necessitate hospitalization, particularly for infants younger than one year old.
The newly introduced nirsevimab offers immediate protection against RSV without requiring the child’s immune system to produce its own antibodies. This makes it particularly suitable for premature infants and children with comorbidities. On the other hand, the recombinant vaccine can be administered to pregnant women, encouraging their immune response so the antibodies can be transferred to the fetus. This aims to shield the newborn during their most vulnerable early months of life.
At the 137th Ordinary Meeting of the National Commission for Incorporation of Technologies (Conitec), the inclusion of these protective measures was deemed to significantly benefit infant health by preventing numerous hospitalizations and fatalities associated with RSV. The Ministry of Health asserts studies submitted to Conitec reveal the vaccine for pregnant women could prevent around 28,000 hospitalizations annually, potentially protecting approximately 2 million infants during the initial months of their lives.
Prior to this decision, the main preventive option available within Brazil’s Unified Health System (SUS) was palivizumab, which is prescribed for extremely premature infants, those born at or before 28 weeks of gestation, as well as children with chronic lung disease or severe congenital heart disease up to the age of two. With the inclusion of nirsevimab, authorities anticipate extending protection to 300,000 additional children than provided under current protocols.
The SES has reported it awaits the official publication of the ordinance from the Ministry of Health to arrange for the vaccination rollout. The Campinas municipality has also expressed eagerness for this announcement to begin implementing immunization plans within public health networks.
Health officials are optimistic about the new vaccine’s arrival, particularly for at-risk populations. "This is not just about the numbers," said José Geraldo Leite, epidemiologist, at the announcement. "We are talking about lives being saved and significant impacts on child health outcomes across Brazil. The introduction of these technologies signifies meaningful progress in safeguarding the health of our children. It is particularly important during periods of high RSV circulation and the resulting surge of respiratory infections, which often overwhelms our healthcare systems."
Meanwhile, maternal vaccination is set to be recommended between 32 and 36 weeks of gestation. This strategy ensures infants are born with protective antibodies against RSV, lasting effectively up to six months after birth, covering what is deemed the most vulnerable phase for respiratory infections.
According to the Secretary of Science, Technology, and Innovation, Carlos Gadelha, this advancement exemplifies science serving public health and demonstrates the government’s commitment to child wellbeing and healthcare sustainability. Reports indicate RSV is responsible for around 80% of bronchiolitis cases and up to 60% of pneumonia cases among children under two years old.
From 2018 to 2024, hospitals recorded over 83,740 admissions of premature infants due to complications related to RSV. With the addition of nirsevimab and the maternal vaccine for pregnant women, Brazil is poised to take significantly proactive steps against RSV, marking important milestones toward reducing infant mortality and hospitalizations.
While the public health program plans for broadening access to these new protective measures, health experts continue advocating for immediate strategies to alleviate the existing ballooning instances of RSV-related illnesses.
Finally, as the new vaccine approaches roll-out, families are reassured they will have access without the prohibitive costs often associated with private clinics. With the right support and timely implementation, health officials aim to curtail the increasing trend of RSV infections and improve health outcomes across communities nationwide.