The CDC has issued a health advisory to provide options for clinicians to protect infants from respiratory syncytial virus (RSV) in the context of a limited supply of nirsevimab, a long-acting monoclonal antibody immunization product recommended for preventing RSV-associated lower respiratory tract disease in infants.
The manufacturer, Sanofi, reports a limited supply of nirsevimab, particularly the 100mg doses used for infants weighing ≥5 kg. In the context of this shortage, the CDC recommends prioritizing available nirsevimab 100mg doses for infants ≥5kg at the highest risk for severe RSV disease. Recommendations for using 50mg doses (indicated for infants <5kg) remain unchanged at this time.
LAC DPH reminds healthcare providers that there are several ways to protect infants from severe RSV this season (now through March):
- Maternal RSV vaccination. Vaccination of pregnant persons at 32-36 weeks of gestation provides protection to newborns and infants through 6 months of age. For more information, see ACIP recommendations. Information for patients available at CDC RSV Vaccination for Pregnant People.
- Immunization of infants weighing < 5 kg with 50 mg dose nirsevimab. Nirsevimab should be administered to infants < 5kg in the first week of life if: the birth mother did not receive RSV vaccine during pregnancy; the birth mother’s RSV vaccination status is unknown; or if the infant was born within 14 days of maternal RSV vaccination (including all infants born at <34 weeks’ gestation). Birthing hospitals and newborn providers should purchase 50 mg doses of nirsevimab and begin or continue administering these doses to all infants <5kg, including all newborns born to birth mothers who did not receive maternal vaccine. Additionally, birthing hospitals can become Vaccine for Children Providers and administer nirsevimab to newborns who are eligible for VFC. To learn more about the VFC program, please see. https://eziz.org/vfc/enrollment.
- Immunization of infants weighing >5kg with remaining 100 mg dose nirsevimab should be prioritized as recommended in the CDC advisory.
