Palivizumab Effectiveness in Preventing Respiratory Syncytial Virus-Associated Hospitalization in High-Risk Infants and Children
Bibliographic record
Abstract
Background. Severe respiratory syncytial virus (RSV)-associated acute lower respiratory tract infections (aLRTI) occurs in children with chronic lung disease of prematurity, congenital heart disease, and preterm birth ≤35 weeks gestational age (wGA). Palivizumab, a monoclonal antibody administered monthly, is used for preventing serious RSV aLRTIs in these infants and children. Its effectiveness in clinical practice is not well studied. Methods. Between 2002 and 2006 a multicenter study was conducted among such high risk children <24 months of age admitted with aLRTI to determine the prevalence of human metapneumovirus (HMPV). Nasopharyngeal aspirates were tested for HMPV and RSV using PCR. Demographic, epidemiological, and clinical data were collected including palivizumab administration within the preceding 30 days. A test-negative case-control design was used to determine palivizumab effectiveness (PE). We compared the odds of palivizumab administration between RSV cases and controls (OR). RSV PE (%) was estimated as (1-OR) × 100. This analysis is restricted to the RSV season (November–April) in United States and Canadian sites. Results. Of 1162 enrolled children, 849 (73%) were eligible. Exclusions primarily included enrollment outside the United States or Canada (184) or outside the RSV season (93). Palivizumab was used in 434 children (51%). Palivizumab use was more common among those who were older (6.2 versus 3.8 mo), were more premature (29 versus 34 wGA), had lower birthweight (1300 versus 2150 grams), had prior NICU admission (91% versus 74%), and had a longer NICU admission (64 versus 18 days) (p < 0.0001 for all comparisons). RSV was identified in 403 infants (47.5%). The PE point estimate was 43% (95% CI, 34% to 51%). In contrast, the PE point estimate was −4% against HMPV (95% CI, −55% to 30%) among RSV negative children. Conclusion. Using a test-negative case-control design with molecular detection of RSV, Palivizumab effectiveness was 43% (95% CI, 34% to 51%) against aLRTI requiring hospitalization but confounding likely lowered this point estimate. Disclosures. E. J. Anderson, Abbvie: Consultant, Consulting fee. MedImmune: Investigator, Research grant. Roche: Editorial assistance in writing a manuscript, Editorial assistance in writing a manuscript; P. Carosone, Medimmune: Grant Investigator, Research support R. Yogev, MedImmune: Speaker's Bureau, Speaker honorarium; E. A. F. Simões, MedImmune: Grant Investigator and Scientific Advisor, Consulting fee and Research grant
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".