Infants younger than six months bear the brunt of hospitalizations and associated costs from respiratory syncytial virus (RSV) in Canada, according to new UBC Faculty of Medicine research that underscores the cost savings of protecting this vulnerable age group from serious lung infections.
Dr. Nirma Khatri Vadlamudi
The study, published in Lancet Regional Health – Americas, looked at more than 29,000 hospitalizations across Canada between 2017 and 2023. It found that babies under six months made up almost 45 per cent of all RSV-related hospital admissions and nearly 50 per cent of the total costs.
“This virus hits our youngest children the hardest,” said Dr. Nirma Khatri Vadlamudi, who led the study during her postdoctoral research at UBC’s Faculty of Medicine. “Even though RSV affects kids of all ages, the health and financial burden is most severe in infant cases.”
RSV is a leading cause of bronchiolitis and pneumonia in children. While most kids catch RSV before age two, some get sick enough to need hospital care — especially babies born early or with other health issues. But the study found that over 80 per cent of hospitalized children had no known risk factors. Even healthy infants are vulnerable.
The researchers used data from the Canadian Institute for Health Information (CIHI) and the Canadian Immunization Monitoring Program ACTive (IMPACT) to track hospital stays, ICU admissions and costs. They found that the average annual cost of RSV hospitalizations was $66 million, with $32 million spent on infants under six months.
Dr. Julie Bettinger
“These numbers are eye-opening and really make a strong case for prioritizing the youngest group in our prevention efforts,” said Dr. Julie Bettinger, senior author and a professor in the UBC Faculty of Medicine’s department of pediatrics and investigator at the BC Children’s Hospital Research Institute.
Surge in RSV hospitalizations after the pandemic
The study also showed that RSV hospitalization rates surged after the COVID-19 pandemic. In 2022–2023, the rate for infants under six months jumped to 2,393 per 100,000 children, nearly double the rate from five years earlier.
The researchers believe this spike was likely due to lower immunity in children who weren’t exposed to RSV during pandemic lockdowns, combined with increased testing for respiratory viruses.
Hospital stays varied depending on the severity of illness. Most children were treated in general pediatric wards, but some needed intensive care or mechanical ventilation. The average cost per case ranged from $8,000 for a regular ward stay to over $80,000 for cases needing ventilation in the ICU.
The findings come as Canada rolls out new tools to prevent RSV, including a long-acting antibody and a maternal vaccine approved in 2023. UBC researchers have contributed to evaluating these options through a national study led by the university’s Reproductive Infectious Diseases Program and the Vaccine Evaluation Center, which is helping guide public health decisions on how best to protect newborns.
“This study gives decision-makers the data they need,” said Dr. Vadlamudi. “If we can prevent RSV in infants, we can protect their health and reduce the strain on hospitals and healthcare budgets.”
The authors hope their work will help shape national policies and support the rollout of RSV prevention programs targeting infants, particularly those under six months old.