Respiratory Syncytial Virus (RSV) Vaccine Quick Reference September 2024

RSV Protection for Infants.

To prevent severe RSV disease in infants, the Centers for Disease Control and Prevention (CDC) recommends either maternal RSV vaccination or infant immunization with RSV monoclonal antibodies. Most infants will not need both.

Maternal RSV Vaccination

Pfizer’s Abrysvo is the only RSV vaccine recommended during pregnancy. One dose of maternal RSV vaccine is recommended during gestational weeks 32 and zero days through weeks 36 and six days of pregnancy, administered between September 1 and January 31 of the following year (e.g., Sept. 1, 2024 – Jan. 31, 2025).

Immunization for Infants and Young Children

Nirsevimab (Beyfortus) is a long-lasting monoclonal antibody product for infants from birth through age 19 months. Beyfortus dosage is determined by the infant’s weight and age. There are two presentations of prefilled syringes: 50mg/0.5mL and 100mg/1.0mL. Infants weighing less than five kilograms (less than 11 pounds) receive 50mg/0.5mL. Infants and young children weighing five or more kilograms (greater than or equal to 11 pounds) receive 100mg/1.0mL.

  • One dose of nirsevimab is recommended for infants younger than eight months of age who were born shortly before or are entering their first RSV season. Ohio’s typical RSV season usually starts at the beginning of October and ends the last day of March. Nirsevimab administration for infants begins October 1 and goes through March 31 of the following year.
  • Nirsevimab is recommended for infants younger than eight months of age who were born during or are entering their first RSV season if:
    • The mother did not receive and RSV vaccine during pregnancy.
    • The mother's RSV vaccination status is unknown.
    • The infant was born within 14 days of maternal RSV vaccination. 
  • Infants and children aged eight to 19 months who are at increased risk for severe RSV disease and entering their second RSV season, require a 200mg dose of Nirsevimab. This dose is given by using two 100mg/1mL injections (one in each thigh). The following children aged eight months through 19 months who are at increased risk for severe RSV disease are recommended to get a dose shortly before or during their second RSV season:
    • American Indian/Alaska Native children.
    • Children with chronic lung disease of prematurity who require medical support during the six months before the start of their second RSV season.
    • Children with severe immunocompromising conditions.
    • Children with sever cystic fibrosis. 
  • Children ages eight months and older who are NOT at increased risk of severe RSV disease should NOT receive nirsevimab.
  • Considerations for the use of nirsevimab or palivizumab in infants and young children at increased risk for severe RSV disease are available at the Advisory Committee on Immunization Practices and American Academy of Pediatrics Recommendations for the Use of the Monoclonal Antibody Nirsevimab for the Prevention of Respiratory syncytial Virus Disease.

RSV Protection for Adults

To prevent severe RSV disease in adults, CDC recommends the following groups receive an RSV vaccine:

  • All adults aged 75 years and older.
  • Adults aged 60-74 years who are at increased risk of severe RSV, including:
    • Those with certain chronic medical conditions, such as lunch or heart disease.
    • Persons living in a nursing home or congregate setting.
  • Only one dose is needed.
    • If an RSV vaccine was received last season, no additional doses are recommended.

There are two sub-protein unit vaccines: Pfizer’s Abrysvo and GSK’s Arexvy; and one mRNA RSV vaccine: Moderna's mRESVIA.

Resources

Nirsevimab:

Adult RSV Advisory Committee on Immunization Practices (ACIP) Vaccine Recommendations:

Contact the Ohio Department of Health: