The American Academy of Pediatrics (AAP) has published updated guidance on the use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus (RSV) infection during the 2022-2023 RSV season.
RSV activity typically begins in the late fall and extends through spring, with peak activity occurring in early February. As of mid-November 2022, there has been a surge of RSV activity in all regions in the United States with a significant number of hospitalizations and illnesses.
In the updated RSV guidance, the AAP continues to support the use of palivizumab in eligible infants. Palivizumab is a monoclonal antibody currently marketed under the trade name Synagis for the prevention of serious lower respiratory tract disease caused by RSV in pediatric patients. Synagis is administered intramuscularly once monthly throughout the RSV season.
For regions with persistently high levels of RSV disease activity in the fall and winter, the AAP supports providing more than 5 consecutive doses of palivizumab in eligible children. Based on a few published studies, there is no evidence of increased frequency or severity of adverse events with the additional doses, according to the AAP.
The guidance states that “Given this information, together with the known efficacy of palivizumab and unpredictable epidemiology of RSV since the summer of 2021, the AAP recommends programmatic consideration of providing more than 5 consecutive doses of palivizumab depending on the duration of the current RSV surge in a given region of the country.”
The AAP will continue to monitor RSV activity through data provided by the National Respiratory and Enteric Virus Surveillance System.
- American Academy of Pediatrics offers guidance on RSV prophylaxis, handling surge of pediatric patients with respiratory infections. News release. American Academy of Pediatrics. Accessed November 18, 2022. https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-offers-guidance-on-rsv-prophylaxis-handling-surge-of-pediatric-patients-with-respiratory-infections/.
- Updated guidance: use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the 2022-2023 RSV season. News release. American Academy of Pediatrics. Accessed November 18, 2022. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/interim-guidance-for-use-of-palivizumab-prophylaxis-to-prevent-hospitalization/.