AAP: Consider Palivizumab for Atypical Interseasonal RSV

THURSDAY, Aug. 12, 2021 -- Palivizumab, which is usually considered for use to decrease the risk for hospitalization in selected infants at increased risk for severe respiratory syncytial virus (RSV) disease during the typical season, should be considered for use during the current atypical interseasonal spread, according to guidance published by the American Academy of Pediatrics (AAP).

Following implementation of nonpharmacologic interventions for the prevention of COVID-19 in March of 2020, the number of RSV infections decreased rapidly in the United States and remained low through the traditional 2020 to 2021 fall-winter season, and then began to increase in spring 2021. This interseasonal increase in activity represents a deviation from the typical RSV epidemiology and was thought to result from the relaxation of nonpharmacologic interventions.

Given the current atypical interseasonal change in RSV epidemiology, the AAP strongly supports consideration of palivizumab for patients who would be candidates according to current eligibility recommendations. This applies to regions with high rates of RSV circulation, which are typically seen in the fall-winter season.

"The AAP recognizes the importance of maintaining flexible approaches, including early initiation of palivizumab administration, during this atypical interseasonal change in RSV epidemiology in 2021," write the authors of the guidance. "The need for palivizumab administration to eligible infants during this atypical interseason should be supported where activity approaches fall-winter season and should be reassessed at least monthly."

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Posted August 2021