Figure. Flowchart to guide which infants should receive nirsevimab in their 1st RSV season
Figure. Flowchart to guide which infants should receive nirsevimab in their 1st RSV season
This figure is a flow chart that provides guidance on which infants should receive nirsevimab in their first RSV season.
The starting point is a box with a question about whether the mother was vaccinated with the RSV vaccine Abrysvo, at least 2 weeks prior to delivery of the infant.
If the answer is no and the mother has delivered the baby less than two weeks after receiving the RSV vaccine, then an arrow points the reader to a new box. This new box says that the infant is recommended nirsevimab. It also provides the dose amounts by infant weight. For infants weighing less than 5 kilograms, they should receive 50 milligrams of nirsevimab. For infants weighing more than 5 kilograms, they should receive 100 milligrams of niresevimab.
If the answer is yes and the mother has delivered the baby at least two weeks after receiving Abrysvo, then there is a second question about if the infant remains at risk of severe RSV disease. There are two scenarios in which the infant may remain at risk, one is that the infant has a listed risk condition, and two is that the infant has suboptimal RSV antibodies because of certain conditions of their mother. There are seven risk conditions listed. One is preterm birth, which applies to infants born before 32 weeks gestational age. Two is haemodynamically significant congenital heart disease. Three is significant immunosuppression such as solid organ transplant or a primary immune deficiency such as severe combined immunodeficiency. Four is chronic lung disease that requires ongoing oxygen or respiratory support. Five is neurological conditions that impair regulatory function. Six is cystic fibrosis with severe lung disease or if weight for length is less than the 10th percentile. Seven is trisomy 21 or another genetic condition that increases the risk of RSV. The other scenario in the box has two conditions for which an infant may have suboptimal RSV antibodies. One is that they were born to a mother who was severely immunosuppressed when she received the RSV vaccine. Two is that the infant had a treatment associated with loss of maternally derived antibodies such as cardiopulmonary bypass or extracorporeal membrane oxygenation.
If the answer is no and the infant does not fall into one of those two scenarios, then the arrow points to a new box saying the infant is not recommended nirsevimab.
If the answer is yes and the infant does fall into one of those two scenarios, then the arrow points to the box that says the infant is recommended nirsevimab and provides the dose amounts by infant weight, as described previously.
These files may not be suitable for users of assistive technology.