Mom, doctors call on NL 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 didn’t get sick — including respiratory syncytial virus, or RSV.

RSV is a common, highly contagious virus that causes respiratory tract infections. This can be immediately dangerous for babies, leading to hospitalization and – in rare cases – even death.

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

“Just last year, we had two close friends and their children (who) were hospitalized because of RSV. So, this is a very common occurrence.”

Pratt is a dermatologist in St. John’s. She delved into medical research during her pregnancy, observing 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 nersevimab as first-line prevention of severe RSV for newborns and young infants,” he said.

Nirsevimab is a monoclonal antibody, also known by its brand name Beaufortus. it was Approved by Health Canada in April 2023 And recommended for all infants in their first RSV season. Single-dose medicine given to infants soon after birth Provides protection for approximately 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. 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 vaccination program for all infants.”

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

Coverage only for high-risk infants

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

according to provincial health departmentThat group includes children under two years of age with chronic lung or congenital heart disease and babies born “less than or equal to 30 weeks” prematurely.

That criteria did not include Pratt’s sons, who were born a little more than two weeks before the cut-off.

Pratt said, “When they’re born that early, you don’t know which direction things are going to go. So, it was a very stressful time.”

“Knowing that there was this option out there that could keep them from getting serious illness or being hospitalized… I was disappointed that we weren’t able to access what has now really become the standard of care.”

It’s a view that is shared by health care professionals across the country who advocate for widespread access to the drug.

“RSV is a terrible disease for babies. One in 50 babies will be hospitalized in their first year of life, and that’s usually because of RSV,” Dr. Shelley Ross told CBC News from Vancouver.

“Every baby, no matter their postal code, deserves protection from RSV.”

Ross is a past president of the Federation of Medical Women of Canada and co-chair of its RSV Task Force. He said that the approval of two new products is a big achievement.

“I think when you look back in time, they would say that the introduction of vaccines to prevent RSV in childhood was a highlight of this last century.”

“What a chance to change things.”

Ross said the federation is actively advocating with provincial governments to expand coverage — something that has already proven successful.

Ross said, “What we’ve seen in provinces that have implemented these measures: dramatic improvements in reductions in emergency room visits, hospital admissions, ICU admissions. So, we know both of these vaccines work, and we know they’re safe.”

Effectiveness of antibodies supported by data

This sentiment is echoed by the Society of Obstetricians and Gynecologists of Canada, which aims to achieve universal RSV protection.

And while a growing number of provinces “have come on board,” Newfoundland and Labrador “lags far behind,” said society spokesperson Dr. Darin El-Char.

She practices in Ontario as a maternal fetal medicine specialist at the Ottawa Hospital and as a physician-scientist at the Ottawa Hospital Research Institute. He said Ontario is the only province that is covering both the antibody shot and the maternal vaccine and is seeing significant impact.

“If you look at our Ontario respiratory (virus) tool, when you look at the impact of hospitalizations, between the peak of the first season and that year, there was a difference of 162 hospital beds, which were down,” El-Char said.

“And already, we’re seeing similar trends for this year’s respiratory season.”

He said that in neighboring Quebec, which covers infant antibodies, the results have been similar — seeing an 86 per cent reduction in emergency visits, an 89 per cent reduction in hospitalizations, and an 88 per cent drop in ICU admissions.

“SGOC strongly maintains that these products… should be universally publicly funded at this time during the RSV season,” El-Char said.

But there is no sign of a change in policy in Newfoundland and Labrador.

While the province is “now exploring nirsevimab a little more closely,” C.Chief Medical Officer of Health Dr. Janice Fitzgerald said there are no concrete plans to expand coverage.

“Certainly, NACI has recommended that provinces consider moving toward a universal coverage, and that could be phased in, taking into account the logistics context, financial considerations,” Fitzgerald said.

“There are a lot of things to consider. We’re exploring … what that might look like here, but we haven’t reached any conclusions.”

This is despite RSV cases increasing in recent years, according to data provided by the health department. In the 2021-22 season, 196 cases – or 1.6 percent of all tests – were found. That number rose to 1,062 cases in the 2024–25 season, or 3.9 percent of all tests.

By the end of January, 74 cases had been detected.

When asked about the number of RSV-related hospitalizations, intensive care unit admissions and deaths, the department said it was “not able to provide data on serious outcomes.”

Fitzgerald said, based on historical information from hospitalization data, ““We’re certainly seeing increased hospitalizations and ICU admissions, especially for infants.”

Private shopping out of reach for many

As of October 6, 2025, nirsevimab is available for private purchase across Canada. For this RSV season, Pratt and her husband decided to pay for their sons out of their own pocket.

“It certainly has the most benefit for newborns and children under eight months of age, but there are still benefits For young infants receiving it after that period,” Pratt said.

“It gives us a lot of peace of mind as parents, knowing they have that protection.”

He said how important safety is became clear recently when one of his sons ended up in the intensive care unit due to bacterial pneumonia.

“To be in that position as a parent and see your child struggling to breathe, it’s hard to put into words what that’s like. It really stays with you,” Pratt said.

“This shows how quickly even healthy babies can become sick to the point of being life-threatening.”

While antibodies may vary between $750 and $905, According to the Canadian Medical Women’s AssociationThe list price for maternal vaccine Abrysvo is about $230.

It’s a price point that’s putting personal shopping out of reach for many, Pratt said. As a physician, she said she knows many people struggle to afford medications.

She would like to see a universal access program. Although the upfront cost to public health may be high, he said preventing costly hospitalizations would save money in the long run.

“It’s not fair that a baby born in Ontario can get this drug for free, while a baby born here in Newfoundland and Labrador doesn’t get this drug for free,” he said.

“At the end of the day, I think it’s the right thing to do.”

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