The Centers for Disease Control and Prevention (CDC) offered clinical guidance on preventing respiratory syncytial virus (RSV) in infants via a webinar hosted by the CDC Wednesday, September 27, 2023. 

The CDC now recommends 2 treatment options for the prevention of RSV in infants:

  • the RSV vaccine (Abrysvo) for seasonal RSV vaccination for pregnant people in 32 through 36 weeks gestation,1,2 and
  • (Beyfortus) for all infants less than 8 months of age who are born during or entering their first RSV season and for infants and children aged 8 months through 19 months who are at increased risk for severe RSV and entering their second RSV season.3

Notably, RSV is currently the leading cause of hospitalization in infants in the US, with seasonal activity peaking December through February in most of the US.1,4,5 

The RSV vaccine and nirsevimab are both ACIP-recognized vaccines and will be covered under the Affordable Care Act (ACA).

Abrysvo, which was previously approved for use in adults at least 60 years of age, is currently available. It is anticipated that nirsevimab will be available in early October, although it may not be available in all pediatric settings this season.1

Choosing Between Treatment Options

Although both the maternal vaccination and infant use of nirsevimab are recommended options for preventing RSV lower respiratory tract infection in infants, the administration of only one of these products is recommended in most infants, according to CDC webinar presenter Jefferson Jones, MD, co-lead of the CDC’s RSV Vaccines Pediatric/Maternal Work Group.

Seasonal vaccination is recommended September through January in most of the US, but nirsevimab is recommended for infants born outside of the RSV season or less than 34 weeks gestation.1

Providers are advised to inform pregnant patients about both treatment options and to use shared clinical decision-making to determine which treatment option works best for the patient.1

Insurance Coverage

The RSV vaccineand nirsevimab are both ACIP-recognized vaccines and will be covered under the Affordable Care Act (ACA).3 The ACA requires insurance coverage for all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) at least 1 year after the date of recommendation.

Beginning October 1, 2023, the Inflation Reduction Act (IRA) also requires coverage of ACIP-recommended vaccines without cost sharing for the Medicaid and Children’s Health Insurance Program (CHIP).6 

Nirsevimab and the RSV vaccine are also included in the Vaccines for Children program for individuals less than 19 years of age.1

Source link