Recommendations
Recommendation for infants
An infant RSV antibody is recommended for infants younger than 8 months of age who are born during or are entering their first RSV season (typically fall through spring) if:
- The mother did not receive RSV vaccine during pregnancy, or
- The mother’s RSV vaccination status is unknown, or
- The infant was born within 14 days of maternal RSV vaccination.
The child‘s age on the day the infant RSV antibody is administered should be used to determine if the child is eligible for immunization. Except in rare circumstances, an infant RSV antibody is not needed for most infants who are born 14 or more days after their mother received RSV vaccine.
Providers should talk to parents and recommend an infant RSV antibody for eligible babies. Ideally, babies born during October through March receive an infant RSV antibody during their birth hospitalization. However, administration can occur during any visit to a healthcare setting, including well-child visits.
For infants eligible for RSV antibody with prolonged hospitalizations shortly before or during the RSV season, providers may consider administering RSV antibody during the hospitalization to prevent healthcare-associated RSV disease. This decision should be based on clinical judgment weighing the potential risks and benefits.
Recommendation for some young children
Nirsevimab is recommended for some children (ages 8-19 months) who are at increased risk for severe RSV disease and entering their second RSV season.
The following children ages 8-19 months are recommended to get nirsevimab shortly before or as early as possible during their second RSV season:
- Children with chronic lung disease of prematurity who required medical support (chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) any time during the 6-month period before the start of the second RSV season
- Children with severe immunocompromise
- Children with cystic fibrosis who have either 1) manifestations of severe lung disease (previous hospitalization for pulmonary exacerbation in the first year of life or abnormalities on chest imaging that persist when stable), or 2) weight-for-length <10th percentile
- American Indian or Alaska Native children
Children ages 8 months and older who are not at increased risk of severe RSV disease should not receive an infant RSV antibody. CDC does not currently recommend nirsevimab for anyone aged 20 months or older.
Clesrovimab is not recommended for children over 8 months of age and does not have FDA approval for children entering their second RSV season.
The American Academy of Pediatrics (AAP) publishes recommendations for palivizumab, including considerations for use of palivizumab in the setting of nirsevimab recommendations. Starting December 31, 2025, palivizumab will no longer be available.
