Recommendation for immune prophylaxis of respiratory syncytial virus infection in children

Respiratory syncytial virus (RSV) is the most common pathogen for young children hospitalized with bronchiolitis and pneumonia. Most infections occur below 1 year of age, and almost all children have been infected before 2 years of age. Monoclonal antibodies targeting RSV, such as palivizumab and nirsevimab, are accessible for preventing infection. A committee, consisting of experts in infectious diseases, cardiovascular diseases, and neonatal diseases in children, was assembled by the Pediatric Infectious Diseases Society of Taiwan. Collaborating with the Child Health Research Center at the National Health Research Institutes, Taiwan Pediatric Association, and Taiwan Society of Neonatology, the committee worked to formulate recommendations for immune prophylaxis against RSV infection in children. Palivizumab is recommended for the prevention of RSV infection in high-risk infants under 1 year old with one of the following (1) premature infants with a gestational age <33 weeks, (2) premature infants with a gestational age <35 weeks with chronic lung disease or (3) infants with hemodynamically significant CHD. Nirsevimab is recommended for the prevention of RSV infection in all infants <12 months. The recommendation is not intended as a sole source of guidance in the prevention of RSV infection in children. The provisions listed in this recommendation are comprehensive suggestions made by pediatric experts in Taiwan based on existing medical evidence. This recommendation should be subject to modification in light of additional medical research findings in the future, and these provisions should not be cited as a basis for dispute resolution.