Older infants and young children ≥8 to <24 months of age who are at risk of severe RSV disease are recommended to receive RSV-specific monoclonal antibody before their 2nd or subsequent RSV season
Young children aged 8 to <24 months who have certain risk conditions for severe RSV disease are recommended to receive RSV-specific monoclonal antibody before their 2nd or subsequent RSV season. See Table. Conditions associated with increased risk of severe RSV disease in infants and young children.
This is regardless of whether these at-risk children received a dose of RSV-specific monoclonal antibody in their first RSV season or were born to a mother who received RSV vaccine during pregnancy.
If a child has already received nirsevimab and has since undergone a treatment, such as cardiopulmonary bypass or extracorporeal membrane oxygenation, that may lead to loss of RSV-specific antibodies, a repeat dose is recommended.
Nirsevimab is preferred over palivizumab.
The dose of nirsevimab for an older infant or child is up to 4 times higher than the dose for a newborn. See Vaccines, dosage and administration.
Timing of RSV-specific monoclonal antibodies in at-risk children entering their 2nd or subsequent RSV season
Timing of RSV-specific monoclonal antibodies in at-risk children entering their 2nd or subsequent RSV season
Nirsevimab offers protection for at least 5 months. Protective benefits can be maximised if it is administered shortly before the start of the RSV season. This is typically April to September in temperate regions of Australia, although this may vary for different regions. Local advice should be sought.
Infants and young children who are at risk of severe RSV disease and who have previously had an RSV infection and are recommended to receive RSV-specific monoclonal antibodies can receive it once recovered.
A minimum interval of 6 months is recommended between each season’s dose of nirsevimab. However, a longer interval may be appropriate. The timing of the second dose should consider the timing of the RSV season, the age of the infant and whether they have risk factors for severe RSV disease.
Nirsevimab is funded through state and territory programs for some infants and young children. See state and territory guidance for details of each program.