Effectiveness of palivizumab immunoprophylaxis to prevent respiratory syncytial virus hospitalizations in healthy full-term <6-month-old infants from the circumpolar region of Nunavik, Quebec, Canada
Bibliographic record
Abstract
In Quebec, Canada, eligibility for palivizumab (PVZ) immunoprophylaxis was expanded in fall 2016 to include healthy-full-term (HFT) infants residing in the circumpolar region of Nunavik and aged <3 months at the start of the RSV season or born during the season. This study assessed the effectiveness of PVZ to prevent RSV hospitalizations in these infants during the 3 seasons following its implementation. Medical and laboratory records of <1-year-old infants (375 average annual birth cohort) admitted to regional and tertiary hospitals with respiratory infection during 6 years were reviewed. Individual pharmacy data and birth registries were used to estimate adherence to PVZ and direct PVZ effectiveness in 0-5-month-old HFT infants by comparing the incidence of RSV hospitalizations 1) in protected and unprotected infants, and 2) during PVZ-protected and unprotected days. Over six seasons, the RSV hospitalization rate was 50.2/1000 (72.6/1000 adjusted for underdetection) in <1-year-old infants. PVZ was administered to 73% (469) of eligible HFT infants; 37% (237) received all recommended doses. Overall for the three RSV seasons the incidence of RSV hospitalization in PVZ-protected infants was similar to PVZ-unprotected infants, resulting in PVZ direct effectiveness of -6.7% (95% CI -174.8%, 85.6%). The incidence of RSV hospitalization during PVZ-protected and during PVZ-unprotected days was also similar, resulting in PVZ direct effectiveness of -3.8% (CI -167.6%, 64.9%). Over three RSV seasons, there was no evidence that PVZ reduced RSV hospitalizations in HFT Nunavik infants. In addition, the sub-optimal adherence to the recommended PVZ administration schedule suggests feasibility and acceptability issues.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 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".