The FDA and ACIP approved a new treatment for the prevention of severe
RSV that will be available with some limitations this fall. Nirsevimab
is a monoclonal antibody injection that provides immediate protection
against severe RSV and should last at least 5 months, the typical
length of RSV season. In conjunction with the AAP, our office
recommends this for the following ages:
• One dose of nirsevimab is recommended to be given during or right
before the RSV season to all babies younger than 8 months of age.
• One dose is recommended to be given to some children aged 8 to 19
months who are entering their second RSV season and are at higher risk
of serious illness. There are strict guidelines for this age group which include:
> 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 who are severely immunocompromised.
> Children with cystic fibrosis who have 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 have weight-for-length that is <10th percentile.
> American Indian and Alaska Native children (note that this is a new
group for whom second-season prophylaxis is recommended in contrast to
the current palivizumab recommendations).
We anticipate having a full supply for those patients receiving VFC
vaccines – those with state insurance or that are uninsured. As this
is a new treatment, it is yet uncertain whether or not private
insurance will cover this for the first season. If they do not, the
cost will fall to patient responsibility. We would love to be able to
give this to all of our young patients, but understand that it may be
cost prohibitive for many families. To remain transparent, this
treatment is quite expensive and unfortunately, is cost prohibitive for
providers as well. If you are interested in your child receiving this
treatment, we encourage you to contact your insurance company to check
on coverage. You can use the following code when you contact them:
90380 (for weight <5kg) and 90381 (weight >5kg).
Should you wish to proceed with or without coverage or have further questions,
please contact us to discuss the details of pricing and scheduling. We do not
yet have the treatment in stock, but plan to order in small amounts
based on the need.
Please see the links below for more information on what we hope is a
game changing preventative treatment for RSV in infants. We look
forward to a time when this treatment will be universally available,
and please know that Dr. Young is working diligently in IL and MO to
improve access for all eligible children.
• RSV: When It's More Than Just a Cold - HealthyChildren.org
•
https://www.chop.edu/centers-programs/vaccine-education-center/vaccine-details/rsv-vaccine-monoclonal-antibody
•
https://www.chop.edu/video/preventing-rsv-babies-scientific-milestone-august-2023-news-brief