Sanofi, Swiftwater, PA, USA.
Merative, Cambridge, MA, USA.
Vaccine. 2023 Sep 15;41(40):5820-5824. doi: 10.1016/j.vaccine.2023.06.089. Epub 2023 Aug 15.
New extended half-life antibodies for the single-dose prevention of medically attended (MA) respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) have been developed for administration to all infants before or during their first RSV season. For infants born during the season, administration as soon as feasible after birth would provide optimal protection and minimize access disparities. The objective of this study was to assess the time from birth hospitalization discharge to the first outpatient visit (FOV) among US infants in order to determine optimal site of administration for the extended half-life antibody.
This retrospective, observational, time-to-event analysis uses the Merative™ MarketScan® Commercial and Multi-State Medicaid Databases. Time to FOV is reported separately for the COVID-19 and recent pre-COVID-19 eras and for commercially insured and Medicaid infants.
Overall, 73.8 % of Medicaid infants had an FOV within 5 days as compared to 84.7 % of commercially insured infants. Estimates were higher during the COVID-19 era. Urban commercially insured infants had much higher FOV completion than their counterparts. Among Medicaid infants, urban Black and rural White infants were least likely to complete their FOV within 5 days of birth hospitalization discharge.
FOV within 5 days after birth hospitalization discharge for Medicaid infants is substantially lower than that of commercially insured infants. Approximately 1 in 4 Medicaid infants and 1 in 8 infants with commercial insurance did not have an outpatient visit within 5 days of birth hospitalization discharge. For US infants born during the RSV season, administration of extended half-life RSV antibodies in the newborn nursery prior to discharge would ensure optimal uptake and minimize access disparities.
为了预防医疗相关（MA）呼吸道合胞病毒（RSV）下呼吸道感染（LRTI），开发了新的长半衰期抗体，用于所有婴儿在首个 RSV 季节前或期间进行单剂量接种。对于在 RSV 季节出生的婴儿，在出生后尽快给药将提供最佳保护并最大程度减少获得机会的差异。本研究的目的是评估美国婴儿从出生住院出院到首次门诊就诊（FOV）的时间，以确定长半衰期抗体的最佳给药部位。
这是一项回顾性、观察性、事件时间分析，使用 Merative ™ MarketScan ® 商业和多州医疗补助数据库。分别报告 COVID-19 和最近的 COVID-19 前时代以及商业保险和医疗补助婴儿的 FOV 时间。
总体而言，与商业保险婴儿相比，84.7%的医疗补助婴儿在 5 天内进行了 FOV，而 Medicaid 婴儿中有 73.8%在 5 天内进行了 FOV。在 COVID-19 时代，估计值更高。城市商业保险婴儿的 FOV 完成率远高于其他城市。在 Medicaid 婴儿中，城市黑人婴儿和农村白人婴儿最不可能在出生住院出院后 5 天内完成 FOV。
Medicaid 婴儿在出生住院出院后 5 天内进行 FOV 的比例大大低于商业保险婴儿。大约有 1/4 的 Medicaid 婴儿和 1/8 的有商业保险的婴儿在出生住院出院后 5 天内没有进行门诊就诊。对于在美国 RSV 季节出生的婴儿，在出院前在新生儿病房中给予长半衰期 RSV 抗体将确保最佳吸收率并最大程度减少获得机会的差异。
