Clinical decision aid for nirsevimab (Beyfortus™) in infants and children up to 24 months of age who remain at risk of severe RSV disease

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Decision aid to determine if an infant or child up to 24 months of age who remain at risk of severe RSV is eligible to receive nirsevimab. Text alternative follows image.  

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  1. Is the infant or child up to 24 months of age entering their second RSV season without known prior RSV infection?
    1. If yes, does the infant have one of the following risk conditions?
      • Preterm birth <32 weeks gestational age
      • Haemodynamically significant congenital heart disease
      • Significant immunosuppression, such as from solid organ transplant, haematopoietic stem cell transplant, or primary immune deficiencies such as severe combined immunodeficiency (SCID)
      • Chronic lung disease requiring ongoing oxygen or respiratory support
      • Neurological conditions that impair respiratory function
      • Cystic fibrosis with severe lung disease or weight for length <10th percentile
      • Trisomy 21 or another genetic condition that increases the risk of severe RSV disease
        1. If yes, nirsevimab is recommended1.
        2. If no, they are not eligible and not recommended to receive nirsevimab.
      1. If no, were​ they born between 1 October 2024 and 16 March 2025 and in their first RSV season without known prior RSV infection?
        1. If no, they are not eligible and not recommended to receive nirsevimab.
        2. If yes, are they not protected through maternal vaccination2 and did not receive nirsevimab at birth
          1. If no, they are not eligible and not recommended to receive nirsevimab.
          2. If yes, do they meet one of the eligibility criteria?
            • Premature infant born less than 37 weeks gestation
            • Aboriginal and Torres Strait Islander
              1. If yes, nirsevimab is recommended1.
              2. If no, does they have one of the other risk conditions?
                • Preterm birth <32 weeks gestational age
                • Haemodynamically significant congenital heart disease
                • Significant immunosuppression, such as from solid organ transplant, haematopoietic stem cell transplant, or primary immune deficiencies such as severe combined immunodeficiency (SCID)
                • Chronic lung disease requiring ongoing oxygen or respiratory support
                • Neurological conditions that impair respiratory function
                • Cystic fibrosis with severe lung disease or weight for length <10th percentile
                • Trisomy 21 or another genetic condition that increases the risk of severe RSV disease
                1. If yes, provide nirsevimab at birth1.
                2. If no, they are not eligible and not recommended to receive nirsevimab.

Notes

  1. The dose of nirsevimab for infants weighing <5 kg, born during or entering their first RSV season, is 50 mg (0.5 mL) via intramuscular (IM) injection. The dose of nirsevimab for infants weighing ≥5 kg, born during or entering their first RSV season, is 100 mg (1 mL).The dose of nirsevimab for older children entering their second RSV season is 200 mg, given as 2 IM injections (2 ×1 mL of the 100 mg/mL formulation) at 2 different sites (preferably separate limbs, or separated by 2.5 cm) in the same visit.
  2. Infants are not adequately protected if they are born within 2 weeks of the mother receiving Abrysvo® during pregnancy.
  3. Eligible infants can receive nirsevimab at their general practice, Aboriginal medical service, or community health service. Primary care providers must use the nirsevimab order form on the NSW State Vaccine Centre to order nirsevimab for each eligible individual.


Current as at: Tuesday 14 January 2025
Contact page owner: Immunisation