News in brief: Chronic respiratory patients eligible for 4th dose of COVID-19 vaccine; Nurse-led asthma teams improve handover care; RSV death toll highest in youngest age group;

Thursday, 26 May 2022

Chronic respiratory patients eligible for 4th dose of COVID-19 vaccine

Patients with chronic respiratory conditions including COPD, cystic fibrosis and interstitial lung disease should all begin receiving a fourth dose of COVID-19 vaccine to protect them for winter, ATAGI says.

The advice, released on Wednesday, applies to anyone aged 16-64 and covers a range of patients deemed at increased risk of severe COVID-19.

It also includes patients with severe asthma, defined as requiring frequent
hospital visits or the use of multiple medications, the expert group said.

Indigenous patients aged 50 and older, aged and disability care residents, those with severe immunocompromise and anyone else over 64 have already been recommended a fourth dose.

As per previous advice, the Pfizer and Moderna vaccines are preferred for booster doses and patients have been advised to wait three months until after their most recent SARS-CoV-2 infection before vaccination.

Nurse-led asthma teams improve handover care

An alternative model of care, a nurse-led Asthma Care Transition Team (ACTT), appears to improve asthma control and self-management skills in patients following hospital discharge.

The Victorian study randomised 60 inpatients with asthma to either usual care or the ACTT which included extra nurse-led reviews at 1 and 6 weeks post-discharge.

The study found the Asthma Control Questionnaire (ACQ) scores improved significantly in both groups but more so with ACTT.

As well, the ACTT group had a higher uptake of patients using Written Action Plans and there was a trend to reduced re-admissions.

Read more in the Health Promotion Journal of Australia.

RSV death toll highest in youngest age group

More than 100,000 deaths in under 5s around the globe were caused by RSV-linked acute lower respiratory infection, but almost half of these occurred in children who were younger than six months old, a new analysis has revealed.

The review of global RSV studies, undertaken by a group of international researchers and published in The Lancet, estimated that there were 33 million RSV-linked acute lower respiratory infection episodes in children under five years old in 2019, roughly in line with findings of a previous analysis in 2015.

These likely caused 3.6 million related hospital admissions, 26,300 in-hospital deaths and 101,400 deaths overall, which also showed that the majority occurred outside of the hospital setting, the authors said.

However, looking at narrower age bands, the research showed that children under six months old suffered the highest burden, with 1.4 million hospital admissions, 13,300 hospital deaths and 45,700 overall deaths.

“Given the disproportionally high burden of RSV morbidity and mortality in children aged 0-6 months, passive immunisation programmes targeting the first 6 months of life could have a substantial effect on reducing RSV disease burden,” the authors suggested.

“For example, assuming that RSV passive immunisation could confer 70% protection to infants aged up to 5 months, then this could directly avert up to 864 000 RSV-associated acute lower respiratory infection hospital admissions and 26 800 RSV-attributable deaths globally per year”, they said.


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