Bibliographic information
Recommendation
[Immunization to protect infants against respiratory syncytial virus disease]. For countries deciding to use a long-acting monoclonal antibody as the primary preventive strategy, WHO recommends a single dose at birth, or at the earliest opportunity thereafter if year-round administration is adopted. In a seasonal approach, administration of a single dose of a long-acting monoclonal antibody is recommended for infants and should begin shortly before the start of the RSV season, as well as at birth or the earliest opportunity thereafter for infants born during the RSV season
Recommended
Certainty of evidence
Moderate
Notes and Remarks
The greatest impact in preventing severe RSV disease will be achieved by administering the monoclonal antibody to infants aged under 6 months; however there is still potential benefit among infants up to 12 months of age. Some countries that adopt a seasonal approach may, on the basis of programmatic and financial considerations, choose to administer the monoclonal antibody to infants older than 6 months who are entering their first RSV season. The currently-available formulation of nirsevimab is a single dose recommended to be given in 2 dosages: either 50 mg for infants weighing <5kg or 100 mg for infants ≥5kg. For programmatic simplicity, countries may opt to use the 50 mg dose of nirsevimab for all birth doses to newborns as it is likely to be adequate for most babies born in most LMIC settings.