Materiały źródłowe

• #1 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9961958/

  Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract disease, especially in young children. […] Despite its global impact on healthcare, related to its high prevalence and its association with significant morbidity, the current therapy is still mostly supportive. […] Moreover, while more than 50 years have passed since the first trial of an RSV vaccine (which unfortunately caused enhanced RSV disease), no vaccine has been approved for RSV prevention. […] In the last two decades, our understanding of the pathogenesis and immunopathology of RSV have continued to evolve, leading to significant advancements in RSV prevention strategies. […] These include both the development of new potential vaccines and the successful implementation of passive immunization, which, together, will provide coverage from infancy to old age.

• #1 Respiratory Syncytial Virus Prophylaxis in Special Populations: Is it Something Worth Considering in Cystic Fibrosis and Immunosuppression?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3208444/

  Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of infant hospitalization in the United States. Prophylaxis with palivizumab is effective in reducing RSV hospitalizations in premature infants and in infants or children with chronic lung disease or congenital heart disease. […] Patients with CF or those who are immunocompromised may be at increased risk for RSV infection-related complications; hence, prophylaxis may prove beneficial to these populations. […] The extent of palivizumab use in the CF and immunocompromised populations is variable. Palivizumab appears to be safe and may be effective in infants and young children with CF and immunocompromise. However, well-designed, randomized, controlled trials published in peer-reviewed journals are lacking, and its routine use can therefore not be recommended at this time. If used in patients with CF or those who are immunocompromised, RSV prophylaxis should be restricted to peak outbreak months in order to optimize the cost benefit of palivizumab.

• #1 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9961958/

  However, adverse reactions (generally mild) occurred in 5% of the RSV IVIG infusions. […] The second strategy of RSV passive immunization was the development of palivizumab (Synagis), a humanized mAB against the RSV fusion (F) glycoprotein, inhibiting RSV entry and infection. […] Palivizumab is administered intramuscularly on a monthly basis during the RSV season. […] A recent Cochrane review found that prophylaxis with palivizumab reduced the rate of hospitalization due to RSV infection by 56%. […] The main disadvantage of palivizumab is the cost and limited duration of effect based on the half-life of the antibody. […] The need for repeated monthly administration is associated with missed doses, reducing the treatments overall efficacy, and the cost has limited its widespread use, especially in low-income countries.

• #1

  https://journalce.powerpak.com/ce/respiratory-syncytial-virus-infection

  Palivizumab is given as an intramuscular injection at a dosage of 15 mg/kg administered monthly for a maximum of 5 months during RSV season. […] The first dose should be administered at the onset of RSV season, which can vary from early September to December. […] Five doses of palivizumab are estimated to achieve the high plasma levels necessary to provide more than 6 months of adequate protection; therefore, no more than five doses are recommended. […] RSV resistance to palivizumab has been detected in up to 5% of children admitted with breakthrough infections while receiving prophylaxis. […] If an outbreak occurs in a high-risk hospital unit during RSV season, strict infection-prevention measures, including adequate hand and cough hygiene, should be emphasized. […] Pharmacists can play a key role in educating parents, family members, and patients about important infection-prevention measures for lowering the risk of RSV acquisition or transmission.

• #1 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  Owing to the shift in RSV seasonality noted in spring 2021 and the surge of RSV cases in fall 2022, the American Academy of Pediatrics supports providing more than 5 consecutive doses of palivizumab to eligible children in regions with disease activity lasting more than the typical 6-month duration. […] According to the 2022 modification of these guidelines, the following are candidates for palivizumab prophylaxis: Infants younger than 24 months who have hemodynamically significant congenital heart disease (cyanotic or acyanotic lesions) or who have chronic lung disease and are off oxygen or pulmonary medications for less than 6 months at the start of the RSV season. […] Premature infants born at 28 weeks gestational age or less who are younger than 1 year chronologic age at the start of the RSV season; once treatment is initiated, it is administered as once-monthly intramuscular injection throughout the season and not stopped until age 1 year.

• #1 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  Premature infants born at 29-32 weeks gestational age who are younger than 6 months chronologic age at the start of the RSV season; once treatment is initiated, it should continue throughout the season and not stop at age 6 months. […] Infants born at 32-35 weeks gestational age who are younger than 3 months chronologic age at the start of or during the RSV season and who either (a) attend child care or (2) have 1 or more siblings or other children younger than 5 years living permanently in the same household; prophylaxis should be provided only until 3 months of age. […] The AAP guidelines highlight child care attendance, school-aged siblings, exposure to environmental pollutants, congenital anomalies of the airway, and severe neuromuscular disorders as primary additional risk factors for these patients.

• #1 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  According to updated recommendations from the AAP in 2022, palivizumab prophylaxis for RSV should be limited to infants born before 29 weeks’ gestation and to infants with chronic illness such as congenital heart disease or chronic lung disease. […] Give infants who qualify for prophylaxis in the first year of life no more than five monthly doses of palivizumab (15 mg/kg per dose) during the RSV season. […] In the second year of life, palivizumab prophylaxis is recommended only for children who needed supplemental oxygen for 28 days or more after birth and who continue to need medical intervention (supplemental oxygen, chronic corticosteroid, or diuretic therapy). […] Clinicians may consider prophylaxis for children younger than 24 months if they will be profoundly immunocompromised during the RSV season.

• #1 Respiratory Syncytial Virus Prophylaxis in Special Populations: Is it Something Worth Considering in Cystic Fibrosis and Immunosuppression?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3208444/

  Based on the potential utility of RSV prophylaxis in this population, the CF Foundation has recommended that palivizumab be considered for infants and children younger than 2 years of age. […] Prophylaxis against RSV may be beneficial in the CF population. […] Currently, the AAP states that specific recommendations regarding the use of palivizumab for prevention of RSV in immunocompromised children cannot be made. However, the guidelines do recognize that individuals with severe immunodeficiency (i.e., severe combined immunodeficiency or advanced acquired immunodeficiency syndrome) may benefit from RSV prophylaxis. […] The role of palivizumab among the immunocompromised population has been evaluated in both animal and phase-I clinical trials. […] Although the CF Foundation has recommended that RSV prophylaxis with palivizumab be considered for infants and children younger than 2 years of age, the extent of palivizumab use in the CF population is variable, with 8.8% to 73.5% of CF centers reporting its use. […] If palivizumab is utilized in the CF or immunocompromised populations, its use should be restricted to peak outbreak months in order to optimize the cost benefit of palivizumab.

• #1 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9961958/

  As such, newer products with longer half-lives have been assessed in several clinical trials. […] Nirsevimab (Beyfortus) is a recombinant human IgG1 kappa monoclonal antibody that binds the F1 and F2 subunits of the RSV fusion (F) protein at a highly conserved epitope. […] This binding locks the RSV F protein in the prefusion conformation to block viral entry into the host cell. […] In a study assessing healthy preterm infants born at 29 to 34 weeks of gestational age, a single injection of nirsevimab administered before the RSV season resulted in a 70% reduction in the incidence of RSV-associated, medically attended LRTI (MALRTI) and a 78% reduction in the number of hospitalizations when compared to the placebo. […] A more recent study assessing nirsevimab’s effect on healthy late-preterm and term infants showed a 75% reduction in MALRTI occurring up to 150 days after the injection in the nirsevimab group versus placebo, without a change in the admission rates.

• #1 Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/72/wr/mm7234a4.htm

  In July 2023, the Food and Drug Administration approved nirsevimab, a long-acting monoclonal antibody, for prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in infants. […] On August 3, 2023, the Advisory Committee on Immunization Practices recommended nirsevimab for infants aged 8 months born during or entering their first RSV season and for infants and children aged 8-19 months who are at increased risk of severe RSV disease entering their second RSV season. […] Nirsevimab can prevent severe RSV disease among infants and children aged 20 months at increased risk for severe RSV disease. […] ACIP recommends 1 dose of nirsevimab for all infants aged 8 months born during or entering their first RSV season (50 mg for infants weighing 5 kg [11 lb] and 100 mg for infants weighing 5 kg [11 lb]).

• #1 Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/72/wr/mm7234a4.htm

  ACIP recommends 1 dose of nirsevimab (200 mg, administered as two 100 mg injections given at the same time at different injection sites) for infants and children aged 8-19 months who are at increased risk for severe RSV disease and entering their second RSV season. […] Providers should administer nirsevimab to infants aged 8 months and to infants and children aged 8-19 months who are at increased risk for severe RSV disease beginning shortly before the start of the RSV season. […] Nirsevimab administration can occur during the birth hospitalization or in the outpatient setting. […] Nirsevimab is not expected to interfere with the immune response to other routine childhood immunizations. […] Given the available evidence, ACIP also recommends nirsevimab for AI/AN children entering their second RSV season.

• #1 RSV Immunization Guidance for Infants and Young Children | RSV | CDC

  https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/infants-young-children.html

  Providers should talk to parents and recommend nirsevimab for eligible babies. Ideally, babies born during October through March receive nirsevimab during their birth hospitalization. However, administration can occur during any visit to a healthcare setting, including well-child visits. […] Nirsevimab is recommended for some children (ages 8 through 19 months) who are at increased risk for severe RSV disease and entering their second RSV season. […] Nirsevimab should be administered October through the end of March in most of the continental United States. […] Infants born during the seasonal administration window (October 1 through March 31) should get nirsevimab within one week after birth ideally during the birth hospitalization. […] For infants born outside of the seasonal administration window (April through September) and for young children who are at increased risk for severe RSV disease and entering their second RSV season, the optimal timing for nirsevimab administration is shortly before the RSV season begins (e.g., October or November).

• #1 RSV Immunization Guidance for Infants and Young Children | RSV | CDC

  https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/infants-young-children.html

  Nirsevimab may be considered for infants born to vaccinated mothers in rare circumstances when, based on the clinical judgment of the healthcare provider, the potential incremental benefit of administration is warranted. […] Nirsevimab is contraindicated in infants and children with a history of severe allergic reactions (e.g., anaphylaxis) to nirsevimab or to any of its components. […] Nirsevimab should be given with caution to infants and children with bleeding disorders. […] Nirsevimab and routine childhood vaccines can be administered during the same visit. No interval between nirsevimab and live vaccines (such as measles, mumps, and rubella [MMR] and varicella) is necessary. […] Early real-world data show that nirsevimab was at least 80-90% effective in preventing babies from being hospitalized with RSV. […] Nirsevimab is a monoclonal antibody recommended to children for the prevention of severe RSV disease. It is not a vaccine. RSV vaccines (GSK’s AREXVY, Pfizer’s ABRYSVO, and Moderna’s mResvia) have been approved for adults but are NOT approved for use in infants or young children.

• #1 Respiratory Syncytial Virus (RSV) Prevention

  https://www.aap.org/en/patient-care/respiratory-syncytial-virus-rsv-prevention/?srsltid=AfmBOopUepntSCAQeoFOJxruwWlhvS2beh6LMpdiF_6SnEVQxnGiaggW

  It is time to think about the next RSV season. […] Ample supply of nirsevimab is expected. […] Nirsevimab is a monoclonal antibody product that offers protection against RSV infection during the RSV season. It is included in the Vaccines for Children Program and is recommended for all infants (not otherwise protected through vaccination during pregnancy). […] RSVpreF (Abrysvo) is a vaccine for pregnant people to protect their infants from RSV. Antibodies developed by the mother are transferred to the fetus, to help protect the baby once they are born. […] Updated Guidance for Palivizumab Prophylaxis Among Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection. […] This report indicates nirsevimab effectiveness was 90% against RSV-associated hospitalization in infants in their first RSV season. […] The AAP offers resources to help families better understand the risks for severe RSV disease and the benefit of prevention.

• #1 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  Respiratory syncytial virus vaccine (Abrysvo) was approved in August 2023 for active immunization of pregnant individuals at 32 through 36 weeks’ gestation for the prevention of lower respiratory tract disease (LRTD) and severe LRTD caused by RSV in infants from birth through 6 months of age. […] The Centers for Disease Control and Prevention (CDC) recommends one dose of the RSV vaccine Abrysvo for pregnant persons who are 32 0/7 weeks through 36 6/7 weeks gestation.

• #1 Respiratory syncytial virus (RSV) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

  Vaccine for pregnant people. The FDA approved an RSV vaccine called Abrysvo for pregnant people to prevent RSV in infants from birth through 6 months of age. A single-dose shot of Abrysvo can be given sometime from 32 weeks through 36 weeks of pregnancy during September through January in the U.S. […] Older adults have weaker immune systems, especially those with ongoing conditions, such as heart or lung disease. To help prevent RSV infection, the FDA approved RSV vaccines for adults age 60 and older. […] The CDC recommends that adults age 60 and older talk with their healthcare professional about getting an RSV vaccine, especially if they’re at higher risk of getting severe RSV. Two vaccines are available for this age group: Abrysvo and Arexvy. The CDC does not recommend one over the other. Each is a single-dose shot.

• #1

  https://www.nationalperinatal.org/rsv

  If you’re pregnant, get vaccinated against RSV – ACOG recommends the Pfizer RSV vaccine if you are 32 to 36 weeks pregnant from September to January. The vaccine creates antibodies that pass to your fetus. This means the baby will have some antibodies to protect them from RSV for the first 6 months after birth.

• #1 Respiratory syncytial virus (RSV) vaccines: Canadian Immunization Guide – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/respiratory-syncytial-virus.html

  Respiratory syncytial virus (RSV) infection is a major cause of lower respiratory tract illness, particularly among infants, young children and older adults. […] Immunization products are available to protect infants and older adults from RSV. […] Immunization products to protect infants from RSV include: two monoclonal antibody preparations, nirsevimab and palivizumab which are administered directly to infants, as well as the RSVpreF vaccine (AbrysvoTM), which is administered during pregnancy to protect the infant through the passive transfer of maternal antibodies. […] Three vaccines are available to protect adults 60 years of age and older from RSV; RSVPreF3 (Arexvy), RSVpreF (AbrysvoTM), and mRNA-1345 (mRESVIA). RSVPreF3 is also available to protect adults 50 to 59 years of age. […] RSV immunization should be considered for any infant entering, or born during, their first RSV season and for infants at ongoing increased risk during their second RSV season.

• #1 Respiratory Syncytial Virus (RSV) Vaccines | CDC Recommendations | AAFP

  https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/disease-pop-immunization/rsv-vaccine.html

  The AAFP endorses the following RSV vaccination recommendations from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention: All adults 75 and older should receive a single dose of an RSV vaccine. Adults 60 to 74 who are at increased risk for severe RSV illness should receive a single dose of an RSV vaccine. […] The RSV vaccine is not currently an annual vaccine, so people who have previously received it do not need to get another dose. […] Administration of both nirsevimab and RSV vaccination for pregnant patients is not needed to protect most infants. […] Nirsevimab (Beyfortus, Sanofi, and AstraZeneca) is only recommended for infants and some young children at increased risk for severe RSV disease. RSV vaccines (Pfizer Abrysvo, GSK Arexvy) are NOT approved for use in infants or young children.

• #1 Respiratory Syncytial Virus Prophylaxis in Special Populations: Is it Something Worth Considering in Cystic Fibrosis and Immunosuppression?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3208444/

  Prevention of RSV during seasonal peaks is critical to reducing RSV-related hospitalization. […] The AAP recommends RSV prophylaxis be considered in patients at highest risk for severe RSV disease: premature infants, infants or children 24 months of age with CLD, infants or children 24 months of age with hemodynamically significant CHD, and premature infants with congenital abnormalities of the airway or neuromuscular disease that compromises the handling of respiratory secretions. […] In these high-risk populations, RSV prophylaxis has been shown to reduce the incidence of RSV-hospitalization 4163% in prospective, randomized, double-blind, placebo-controlled trials. […] Palivizumab, a humanized murine monoclonal antibody, given once monthly during RSV season (typically 5 doses), is the preferred agent for RSV prophylaxis.

• #1 Respiratory syncytial virus (RSV): Prevention and risks – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/respiratory-syncytial-virus-rsv/prevention-risks.html

  Use personal protective measures to help reduce your risk of getting or spreading RSV: […] Properly wear a well-fitting respirator or mask, as this helps protect those around you from getting sick. […] It’s especially important to wear a mask if you’re sick and need to be around other people or must enter a public place. […] Wash your hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol. […] Cough or sneeze into a tissue or your elbow (not your hand). […] Avoid touching your eyes, nose or mouth with unclean hands. […] Improve indoor ventilation when possible, such as opening windows or doors. […] Clean and disinfect high-touch surfaces and objects, such as doorknobs, toys or furniture. […] There are some products that have been shown to prevent RSV disease.

• #1 Respiratory syncytial virus (RSV) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

  These lifestyle habits can help prevent the spread of this infection: Wash your hands often. Teach your children the importance of hand-washing. […] Avoid exposure. Cover your mouth and nose when you cough or sneeze. Limit your baby’s contact with people who have fevers or colds. […] Keep things clean. Make sure kitchen and bathroom countertops, doorknobs, and handles are clean. Put used tissues in the trash right away. […] Don’t share drinking glasses with others. Use your own glass or disposable cups when you or someone else is sick. Label each person’s cup. […] Don’t smoke. Babies who are exposed to tobacco smoke have a higher risk of getting RSV and potentially more-severe symptoms. If you do smoke, never do so inside the house or car. […] Wash toys regularly. Do this especially when your child or a playmate is sick.

• #1 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  Transmission of RSV appears to occur via contact with infected secretions through hand-to-hand spread or fomites and respiratory droplets, with an incubation period of 3-5 days. […] In the hospital setting, isolation of patients infected with RSV as a group and wearing of masks and gowns during close contact with infected children are important in controlling nosocomial spread. […] Nirsevimab (Beyfortus) is indicated for prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in newborns and infants entering or during their first RSV season and children up to 24 months old who remain vulnerable to severe RSV disease through their second RSV season. […] The American Academy of Pediatrics (AAP) guidelines for RSV prophylaxis attempted to address these issues by grading the indications for preventive therapy according to degree of prematurity or risk factor.

• #1 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9961958/

  Unfortunately, the initial formalin-inactivated RSV vaccine showed that upon natural exposure to RSV, infants who were vaccinated experienced vaccine-enhanced RSV disease (ERD), with an 80% admission rate and the death of two infants. […] The ERD phenomenon has since been studied extensively and is believed, in part, to be secondary to an exaggerated memory Th2 response, poor antibody affinity maturation, inadequate toll receptor signaling, and a low CD8 T-cell response. […] ERD stalled the development of RSV vaccines for many years due to safety concerns; however, as our understanding of RSV structural biology and the mechanism of action has continued to evolve, there have been many advancements in RSV prevention strategies. […] The different preventive approaches could be classified into two categories: firstly, passive immunization with monoclonal antibodies (mAB) or maternal vaccination during pregnancy, and secondly, active immunization by various types of vaccines designed for infants and adults.

• #1 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9961958/

  These differences were consistent throughout the study period and across RSV subtypes. […] Importantly, the safety profile of nirsevimab was reported to be similar to that of palivizumab. […] To summarize, there are currently many maternal and infant RSV vaccines in different clinical trials, together with the continuous evaluation of newer mABs, with some of these studies showing promising results. […] The future management of RSV prevention will likely combine the different strategies of active and passive immunization.

• #2 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://www.mdpi.com/2076-0817/12/2/154

  Respiratory syncytial virus (RSV) is a leading cause of severe lower respiratory tract disease, especially in young children. […] Moreover, while more than 50 years have passed since the first trial of an RSV vaccine (which unfortunately caused enhanced RSV disease), no vaccine has been approved for RSV prevention. […] In the last two decades, our understanding of the pathogenesis and immunopathology of RSV have continued to evolve, leading to significant advancements in RSV prevention strategies. These include both the development of new potential vaccines and the successful implementation of passive immunization, which, together, will provide coverage from infancy to old age. […] As the main therapeutic approach for acute RSV infection is supportive care, emphasis remains on the prevention of severe disease and hospitalization.

• #2 Respiratory Syncytial Virus Prophylaxis in Special Populations: Is it Something Worth Considering in Cystic Fibrosis and Immunosuppression?

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3208444/

  Prevention of RSV during seasonal peaks is critical to reducing RSV-related hospitalization. […] The AAP recommends RSV prophylaxis be considered in patients at highest risk for severe RSV disease: premature infants, infants or children 24 months of age with CLD, infants or children 24 months of age with hemodynamically significant CHD, and premature infants with congenital abnormalities of the airway or neuromuscular disease that compromises the handling of respiratory secretions. […] In these high-risk populations, RSV prophylaxis has been shown to reduce the incidence of RSV-hospitalization 4163% in prospective, randomized, double-blind, placebo-controlled trials. […] Palivizumab, a humanized murine monoclonal antibody, given once monthly during RSV season (typically 5 doses), is the preferred agent for RSV prophylaxis.

• #2 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://www.mdpi.com/2076-0817/12/2/154

  The current RSV vaccine candidates can be divided into live-attenuated (LAV) or chimeric vaccines, as well as protein-based, recombinant-vector-based, and nucleic-acid-based vaccines. […] The second strategy of RSV passive immunization was the development of palivizumab (Synagis®), a humanized mAB against the RSV fusion (F) glycoprotein, inhibiting RSV entry and infection. […] A recent Cochrane review found that prophylaxis with palivizumab reduced the rate of hospitalization due to RSV infection by 56%. […] Nirsevimab (Beyfortus®) is a recombinant human IgG1 kappa monoclonal antibody that binds the F1 and F2 subunits of the RSV fusion (F) protein at a highly conserved epitope. […] Importantly, the safety profile of nirsevimab was reported to be similar to that of palivizumab. […] To summarize, there are currently many maternal and infant RSV vaccines in different clinical trials, together with the continuous evaluation of newer mABs, with some of these studies showing promising results. The future management of RSV prevention will likely combine the different strategies of active and passive immunization.

• #2 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  Premature infants born at 29-32 weeks gestational age who are younger than 6 months chronologic age at the start of the RSV season; once treatment is initiated, it should continue throughout the season and not stop at age 6 months. […] Infants born at 32-35 weeks gestational age who are younger than 3 months chronologic age at the start of or during the RSV season and who either (a) attend child care or (2) have 1 or more siblings or other children younger than 5 years living permanently in the same household; prophylaxis should be provided only until 3 months of age. […] The AAP guidelines highlight child care attendance, school-aged siblings, exposure to environmental pollutants, congenital anomalies of the airway, and severe neuromuscular disorders as primary additional risk factors for these patients.

• #2 CDC Endorses Nirsevimab for Infant Respiratory Syncytial Virus (RSV) Prevention

  https://www.contagionlive.com/view/cdc-endorses-nirsevimab-for-infant-respiratory-syncytial-virus-rsv-prevention

  High efficacy of Nirsevimab in preventing RSV hospitalizations was revealed. […] The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices endorsed using nirsevimab, a long-acting monoclonal antibody, for infants under 8 months old to guard against RSV-associated lower respiratory tract infection during their initial RSV season. It recommended nirsevimab for children 8-19 months who are at risk of severe RSV disease. […] Nirsevimab has shown 90% effectiveness in preventing RSV-associated hospitalization among infants who received the treatment more than 7 days before symptom onset. […] Overall, RSV is identified as a high cause of hospital admissions among infants in the US. Despite the limited uptake of nirsevimab and constraints related to the interval from its administration, the early estimates from this analysis reinforce the CDCs recommendation of nirsevimab for preventing severe RSV disease in infants. This conclusion is drawn from the high effectiveness rate of nirsevimab in preventing RSV-associated hospitalization among infants who received it.

• #2 RSV Immunization Guidance for Infants and Young Children | RSV | CDC

  https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/infants-young-children.html

  To prevent severe RSV disease in infants, either maternal RSV vaccination or infant immunization with the RSV monoclonal antibody (nirsevimab) is recommended. Most infants will not need both. […] Administration of nirsevimab is recommended during October through March in most of the U.S. The optimal timing for nirsevimab administration is shortly before the RSV season begins (e.g., October-November), or within a baby’s first week of life if born October through March (ideally during the birth hospitalization). […] Nirsevimab is highly effective in preventing RSV-associated hospitalization. […] Nirsevimab is recommended for infants younger than 8 months of age who are born during or are entering their first RSV season (typically fall through spring) if: The mother did not receive RSV vaccine during pregnancy, or The mother’s RSV vaccination status is unknown, or The infant was born within 14 days of maternal RSV vaccination.

• #2

  https://www.nationalperinatal.org/rsv

  Respiratory Syncytial Virus (RSV) Prevention Clinical Practice Guideline: […] The CDC has recommended this vaccine for all infants less than 8 months of age during their first RSV season. They also recommend this vaccine for infants up to 24 months with certain medical conditions including chronic lung and cardiac disease as well as immunodeficiency. […] Pfizers new bivalent RSVpreF vaccine (Abrysvo) is the first respiratory syncytial virus (RSV) vaccine for pregnant people that protects both them and their newborn from severe RSV illness. […] The CDC recommends seasonal administration of one dose of RSV vaccine for pregnant people during weeks 32 through 36 of pregnancy. […] To prevent RSV-associated lower respiratory tract infections (LRTIs) in infants, the CDC recommends either: administering RSVpreF (Abrysvo) vaccine during pregnancy or administering RSV monoclonal antibody, nirsevimab (Beyfortus) to the infant after birth.

• #2 Respiratory syncytial virus (RSV) vaccines: Canadian Immunization Guide – Canada.ca

  https://www.canada.ca/en/public-health/services/publications/healthy-living/canadian-immunization-guide-part-4-active-vaccines/respiratory-syncytial-virus.html

  Nirsevimab, the RSV monoclonal antibody, is preferred over palivizumab and the RSVpreF (AbrysvoTM) vaccine. […] The RSVpreF (AbrysvoTM) vaccine may be considered by a pregnant woman or pregnant person, together with their care provider, in advance of, or during, the RSV season, to prevent RSV disease in their infant. […] RSV immunization is recommended for adults: 75 years of age and older, particularly for those who are at increased risk of severe RSV disease (List 2) […] A single dose of RSVPreF3, RSVpreF or mRNA-1345 can be used in adults 60 to 74 years of age. […] A single dose of RSVPreF3 can be used in adults 50 to 74 years of age. […] RSV immunizing products are optimally administered just before the start of the RSV season. […] A 0.5 mL dose of RSVpreF (AbrysvoTM) vaccine is administered during pregnancy between 32 and 36 weeks gestation.

• #2 Respiratory syncytial virus (RSV) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

  These lifestyle habits can help prevent the spread of this infection: Wash your hands often. Teach your children the importance of hand-washing. […] Avoid exposure. Cover your mouth and nose when you cough or sneeze. Limit your baby’s contact with people who have fevers or colds. […] Keep things clean. Make sure kitchen and bathroom countertops, doorknobs, and handles are clean. Put used tissues in the trash right away. […] Don’t share drinking glasses with others. Use your own glass or disposable cups when you or someone else is sick. Label each person’s cup. […] Don’t smoke. Babies who are exposed to tobacco smoke have a higher risk of getting RSV and potentially more-severe symptoms. If you do smoke, never do so inside the house or car. […] Wash toys regularly. Do this especially when your child or a playmate is sick.

• #2 Prevention and Treatment Strategies for Respiratory Syncytial Virus (RSV)

  https://www.mdpi.com/2076-0817/12/2/154

  The first vaccination for RSV was assessed shortly after the first isolation of RSV in severely ill babies. […] Unfortunately, the initial formalin-inactivated RSV vaccine showed that upon natural exposure to RSV, infants who were vaccinated experienced vaccine-enhanced RSV disease (ERD), with an 80% admission rate and the death of two infants. […] The different preventive approaches could be classified into two categories: firstly, passive immunization with monoclonal antibodies (mAB) or maternal vaccination during pregnancy, and secondly, active immunization by various types of vaccines designed for infants and adults. […] In the last decade, there has been a significant increase in the number of trials assessing different RSV vaccine strategies. […] There are currently 34 different RSV vaccines in development, and 21 of these are currently advancing through Phase 1 to Phase 3 clinical trials.

• #3 Respiratory Syncytial Virus Infection Treatment & Management: Approach Considerations, Pharmacologic Therapy, Prevention

  https://emedicine.medscape.com/article/971488-treatment

  According to updated recommendations from the AAP in 2022, palivizumab prophylaxis for RSV should be limited to infants born before 29 weeks’ gestation and to infants with chronic illness such as congenital heart disease or chronic lung disease. […] Give infants who qualify for prophylaxis in the first year of life no more than five monthly doses of palivizumab (15 mg/kg per dose) during the RSV season. […] In the second year of life, palivizumab prophylaxis is recommended only for children who needed supplemental oxygen for 28 days or more after birth and who continue to need medical intervention (supplemental oxygen, chronic corticosteroid, or diuretic therapy). […] Clinicians may consider prophylaxis for children younger than 24 months if they will be profoundly immunocompromised during the RSV season.

• #3 Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 | MMWR

  https://www.cdc.gov/mmwr/volumes/72/wr/mm7234a4.htm

  ACIP recommends 1 dose of nirsevimab (200 mg, administered as two 100 mg injections given at the same time at different injection sites) for infants and children aged 8-19 months who are at increased risk for severe RSV disease and entering their second RSV season. […] Providers should administer nirsevimab to infants aged 8 months and to infants and children aged 8-19 months who are at increased risk for severe RSV disease beginning shortly before the start of the RSV season. […] Nirsevimab administration can occur during the birth hospitalization or in the outpatient setting. […] Nirsevimab is not expected to interfere with the immune response to other routine childhood immunizations. […] Given the available evidence, ACIP also recommends nirsevimab for AI/AN children entering their second RSV season.

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