Effectiveness of palivizumab prophylaxis in infants and children in Florida

Abstract

In this community-based study, palivizumab was associated with a reduction in severe RSV infections of a magnitude comparable to the lower clinical trial efficacy estimates. Protection appears to extend beyond the currently recommended monthly dosing schedule.

Partial palivizumab prophylaxis and increased risk of hospitalization due to respiratory syncytial virus in a Medicaid population: a retrospective cohort analysis

“…By contrast, Diehl et al found no significant differences between compliant and noncompliant infants in RSV hospitalization, but this finding may have been impacted by the small sample size (N=245) [3]. Using time-dependent exposure definitions to accommodate intermittent palivizumab dosing, Winterstein et al in a study of Florida Medicaid children found decreases in the risk of RSV hospitalization subsequent to both the initial palivizumab dose and succeeding doses [15]. However, the reduction following the first dose [HR 0.89, 95% CI 0.71-1.12] was not statistically significant.…”

Vitamin D Deficiency and Acute Lower Respiratory Infections in Children Younger Than 5 Years: Identification and Treatment

“…complications (Winterstein, Hampp, & Saidi, 2012). According to the most recent policy on palivizumab of the AAP Committee on Infectious Diseases (2009), high-risk infants should receive palivizumab once a month for a maximum of 5 months during RSV season until they reach 24 months of age, and other premature infants who qualify for prophylaxis should receive palivizumab monthly for a maximum of 3 months during the RSV season.…”

An algorithm to identify preterm infants in administrative claims data

“…In the few studies that have utilized administrative databases for epidemiologic research in preterm infants, researchers have relied on birth certificate data to ascertain prematurity . A key advantage of administrative data is the option to follow mothers and infants over long periods at relatively low data acquisition cost .…”

“…In claims data, prematurity can be identified by the International Classification of Disease version 9, Clinical Modification (ICD‐9‐CM) codes for gestational age, but the validity of these codes and the magnitude of bias introduced by potential misclassification remain unknown. Therefore, investigators have linked claims data with birth certificates, which provide gestational age based on the reported last menstrual period or a clinical estimate . However, with increasing complexity in confidentiality requirements (e.g., social security number (SSN) procurement), linkage of data sources is difficult, and the development of an algorithm to identify preterm births in the absence of birth certificates would greatly facilitate population‐based studies.…”