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AAP continues to support palivizumab use in areas with high rates of RSV

August 29, 2022

The AAP is continuing to support use of palivizumab for eligible infants in areas experiencing high rates of respiratory syncytial virus (RSV).

During the COVID-19 pandemic, RSV has not followed its typical seasonality of late fall through spring, leading the AAP to support use of the monoclonal antibody at other times of the year if activity is comparable to a regular season. Currently, virus activity varies by region.

RSV can cause severe lower respiratory tract disease such as bronchiolitis or pneumonia. Infants younger than 6 months are at highest risk for severe disease, especially during their first fall and winter. Palivizumab is given in five consecutive monthly doses and is believed to provide protection for six months.

Eligible children include infants born at less than 29 weeks’ gestation, infants with chronic lung disease of prematurity, infants with certain types of hemodynamically significant congenital heart disease, infants and young children with certain immunodeficiency states, and infants with pulmonary abnormalities or neuromuscular conditions that impair ability to clear secretions from the upper airway.

Clinicians can monitor regional RSV trends through local specialists and public health officials as well as the Centers for Disease Control and Prevention’s (CDC’s) National Respiratory and Enteric Virus Surveillance System.

About 58,000 children under age 5 years are hospitalized each year due to RSV, and 100 to 500 die from the virus, according to the CDC. Early symptoms in infants and young children include a runny nose, decreased appetite, cough and wheezing. Infants under 6 months may show signs of irritability, decreased activity, decreased appetite and apnea. Some children may have RSV without a fever.





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