{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:52:10Z","timestamp":1792788730511,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pmed.1005223","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000}}],"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"INSERM","award":["International Research Project Award 2025-2030"],"award-info":[{"award-number":["International Research Project Award 2025-2030"]}],"id":[{"id":"https:\/\/ror.org\/02vjkv261","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ESPID","award":["Fellowship 25-27"],"award-info":[{"award-number":["Fellowship 25-27"]}],"id":[{"id":"https:\/\/ror.org\/00jvfh371","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosmedicine.org"],"crossmark-restriction":false},"short-container-title":["PLoS Med"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nirsevimab was introduced to prevent Respiratory Syncytial Virus (RSV) bronchiolitis in infants. Despite its proven effectiveness and similar guidelines across Europe, bronchiolitis reduction varied across Europe. This study explored whether nirsevimab coverage among targeted populations (born in- and out-of-season) was associated to this variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>\n                      We used routinely collected data from 27 pediatric emergency departments across 12 European countries (01\/2018\u201303\/2024). All bronchiolitis cases aged &lt;12 months were included. Regions were classified as intervention or control based on nirsevimab implementation. Coverage was obtained from official regional reports. We estimated changes in monthly case using controlled interrupted time-series models accounting for seasonality and temporal trends, by age-groups (0\u20133 and 3\u201312 months) and regions during the\n                      <jats:italic>intervention<\/jats:italic>\n                      period (10\/2023\u201303\/2024) and examined their correlation to coverage using Pearson\u2019s test. Urinary tract infections served as a control outcome.\n                    <\/jats:p>\n                    <jats:p>\n                      We included 107,088 bronchiolitis cases. Reductions varied widely across regions and age-groups, from +0.6% (95% CI [\u22129.4,\u2009+20.5]) to \u221261.0% (95% CI [\u221267.8, \u221235.2]). Coverage strongly correlated with bronchiolitis reduction across age-groups and regions (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009= \u22120.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Bronchiolitis trends in\n                      <jats:italic>control<\/jats:italic>\n                      countries remained stable, as did urinary tract infections. As an ecological study, causality cannot be inferred and unmeasured regional differences may have contributed to the variability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This multinational interrupted time-series analysis identified coverage as a key factor associated to bronchiolitis reduction across age-groups and European regions. Implementation choices across Europe likely influenced coverage, highlighting that nirsevimab benefits depend not only on its intrinsic efficacy, but also on how effectively it is delivered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pmed.1005223","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:54:11Z","timestamp":1788458051000},"page":"e1005223","update-policy":"https:\/\/doi.org\/10.1371\/journal.pmed.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between nirsevimab coverage and pediatric emergency department visits for bronchiolitis in 12 European countries: An interrupted time-series analysis"],"prefix":"10.1371","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2325-8998","authenticated-orcid":true,"given":"L\u00e9a","family":"Lenglart","sequence":"first","affiliation":[{"name":"Robert Debr\u00e9 University Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris, Paris Cit\u00e9 University","place":["Paris, France"],"department":["Pediatric Emergency Department"]},{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, IAME","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4909-803X","authenticated-orcid":true,"given":"Luigi","family":"Titomanlio","sequence":"additional","affiliation":[{"name":"Robert Debr\u00e9 University Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris, Paris Cit\u00e9 University","place":["Paris, France"],"department":["Pediatric Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5273-2331","authenticated-orcid":true,"given":"Ilaria","family":"Alberti","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico","place":["Milan, Italy"],"department":["Pediatric Emergency Department"]},{"name":"University of Milan","place":["Milan, Italy"],"department":["Department of Clinical Science and Community Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2319-1332","authenticated-orcid":true,"given":"Laura","family":"Almeida","sequence":"additional","affiliation":[{"name":"University of Porto","place":["Porto, Portugal"],"department":["Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7482-0405","authenticated-orcid":true,"given":"Camille","family":"Aupiais","sequence":"additional","affiliation":[{"name":"Jean Verdier Hospital, Bondy, Assistance Publique-H\u00f4pitaux de Paris","place":["Sorbonne Francecit\u00e9, France"],"department":["Pediatric Emergency Department"]},{"name":"INSERM UMR 1123, ECEVE","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Aky\u00fcz \u00d6zkan","sequence":"additional","affiliation":[{"name":"Ondokuz May\u0131s University","place":["Samsun, Turkey"],"department":["Pediatric Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1775-8347","authenticated-orcid":true,"given":"Michael","family":"Barrett","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Ireland at Crumlin","place":["Dublin, Ireland"],"department":["Pediatric Emergency Department"]},{"name":"Women\u2019s and Children\u2019s Health, University College Dublin","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5277-0002","authenticated-orcid":true,"given":"Romain","family":"Basmaci","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, IAME","place":["Paris, France"]},{"name":"Louis Mourier Hospital, Colombes, Assistance Publique\u2013H\u00f4pitaux de Paris, Paris Cit\u00e9 University","place":["Paris, France"],"department":["Pediatric Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-3993","authenticated-orcid":true,"given":"Ahmet","family":"Birbilen","sequence":"additional","affiliation":[{"name":"Hacettepe University School of Medicine","place":["Ankara, Turkey"],"department":["Division of Pediatric Emergency Medicine, Department of Pediatrics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorine","family":"Borensztajn","sequence":"additional","affiliation":[{"name":"NoordWest Ziekenhuisgroep","place":["Alkmaar, The Netherlands"],"department":["Department of 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IRCCS","place":["Rome, Italy"],"department":["Department of Woman and Child Health and Public Health"]},{"name":"Universit\u00e0 Cattolica del Sacro Cuore","place":["Rome, Italy"],"department":["Area Pediatrica, Dipartimento di Scienze della Vita e di Sanit\u00e0 Pubblica"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-5622","authenticated-orcid":true,"given":"Teresa","family":"Campos","sequence":"additional","affiliation":[{"name":"University of Porto","place":["Porto, Portugal"],"department":["Centro Hospitalar e Universit\u00e1rio de S\u00e3o Jo\u00e3o"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0762-7730","authenticated-orcid":true,"given":"Susana","family":"Castanhinha","sequence":"additional","affiliation":[{"name":"Hospital Dona Estefania, Centro Hospitalar Lisboa Central","place":["Lisbon, Portugal"],"department":["Pulmonology Unit, Department of 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Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4984-4058","authenticated-orcid":true,"given":"Laszlo","family":"Fodor","sequence":"additional","affiliation":[{"name":"Szent Gyorgy University Teaching Hospital of Fejer County","place":["Szekesfehervar, Hungary"],"department":["Pediatric Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6542-4494","authenticated-orcid":true,"given":"Borja","family":"Gomez","sequence":"additional","affiliation":[{"name":"Biobizkaia Health Research Institute, Hospital Universitario Cruces","place":["Barakaldo, Basque Country, Spain"],"department":["Paediatric Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3706-8370","authenticated-orcid":true,"given":"Susanne","family":"Greber-Platzer","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Pediatric Emergency Unit, Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Guedj","sequence":"additional","affiliation":[{"name":"Armand Trousseau Hospital, Assistance Publique\u2013H\u00f4pitaux de Paris, Sorbonne Universit\u00e9","place":["Paris, France"],"department":["Pediatric Emergency Department"]},{"name":"CRESS Inserm U-1153 Paris, Epop\u00e9 Team","place":["Paris, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Huege","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Pediatric Emergency Unit, Clinical Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7231-9836","authenticated-orcid":true,"given":"Fiona","family":"Leonard","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Ireland at Crumlin","place":["Dublin, Ireland"],"department":["Pediatric Emergency Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6319-8550","authenticated-orcid":true,"given":"Ian K.","family":"Maconochie","sequence":"additional","affiliation":[{"name":"Division of Medicine, St. Mary\u2019s Hospital","place":["London, United Kingdom"],"department":["Department of Pediatric Emergency Medicine"]},{"name":"Imperial College NHS Healthcare Trust","place":["London, United Kingdom"]},{"name":"Imperial College London","place":["London, United Kingdom"],"department":["Center for Pediatrics and Child Health, Faculty of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3192-3102","authenticated-orcid":true,"given":"Robin","family":"Marlow","sequence":"additional","affiliation":[{"name":"Bristol Royal Hospital for Children","place":["Bristol, United Kingdom"],"department":["Emergency Department"]},{"name":"University of the West of England","place":["Bristol, United Kingdom"],"department":["Faculty of Health and Applied Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3829-4254","authenticated-orcid":true,"given":"Gregorio","family":"Milani","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico","place":["Milan, Italy"],"department":["Pediatric Emergency Department"]},{"name":"University of Milan","place":["Milan, Italy"],"department":["Department of Clinical Science and Community 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of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: a systematic review and modelling study","volume":"390","author":"T Shi","year":"2017","journal-title":"Lancet"},{"key":"pmed.1005223.ref003","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/S1473-3099(18)30310-4","article-title":"Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"C Troeger","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"26","key":"pmed.1005223.ref004","doi-asserted-by":"crossref","first-page":"2425","DOI":"10.1056\/NEJMoa2309189","article-title":"Nirsevimab for prevention of hospitalizations due to RSV in infants","volume":"389","author":"SB Drysdale","year":"2023","journal-title":"N Engl J 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