Clinical decision aid for nirsevimab (Beyfortus™) in newborn infants

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Decision aid to determine if a newborn infant is eligible to receive nirsevimab. Text alternative follows image.  

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  1. Was the infant born or after 1 January 2025?
    1. If no, the infant is not eligible for nirsevimab1
    2. If yes, was the maternal RSV vaccine (Abrysvo) received <2 weeks before birth?2
      1. ​If yes, provide nirsevimab at birth5.
      2. If no, was infant born with risk conditions3 for severe RSV disease regardless of maternal vaccination status.
        1. If yes, provide nirsevimab at birth5.
        2. If no, was mother with severe immunosuppression4 or undergone cardiopulmonary bypass or extracorporeal membrane oxygenation (ECMO) regardless of maternal vaccination status?
          1. If yes, provide nirsevimab at birth5.
          2. If no, nirsevimab not required.

References

  1. Refer to the Clinical decision aid for nirsevimab (Beyfortus™) in infants and children up to 24 months of age who remain at risk of severe RSV disease.
  2. Check maternal RSV vaccination status on the Australian Immunisation Register
  3. Conditions associated with increased risk of severe RSV disease in infants and young children as
    recommended in the Australian Immunisation Handbook include:
    • preterm birth <32 weeks gestational age
    • ongoing 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) in
      consultation with a paediatric infectious disease, immunology or
      immunisation specialist.
    • 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
  4. Refer to the Australian Immunisation Handbook ​Vaccination for people who are immunocompromised chapter
  5. The dose of nirsevimab for infants weighing <5 kg, born during or entering their 1st RSV season, is 50 mg (0.5 mL). The dose of nirsevimab for infants weighing ≥5 kg, born during or entering their 1st RSV season, is 100 mg (1 mL). Nirsevimab is administered by intramuscular injection.

Note: Newborn infants should receive nirsevimab prior to discharge from hospital. Primary care providers with an eligible newborn infant born on or after 1 January 2025 who did not receive nirsevimab before discharge from hospital must use the nirsevimab order form on the NSW State Vaccine Centre to order nirsevimab for each eligible infant.

Current as at: Tuesday 25 March 2025
Contact page owner: Immunisation