Prophylaxis and High-Risk Groups

Palivizumab (say "pah-lih-VIH-zu-mahb") is a monoclonal antibody that reduces hospitalizations due to RSV infection among children at high-risk for severe disease. It is given in monthly intramuscular injections during the RSV season, which generally lasts from November through March in most locations in the United States.

Infants and children at risk for severe illness due to RSV infection

The American Academy of Pediatrics recommends that palivizumab may be considered for the following groups of children

• Infants born at 28 weeks’ gestation or earlier during their first RSV season
• Infants born at 29–32 weeks’ gestation who are up to 6 months of age
• Infants born at 32–35 weeks’ gestation if two or more of the following risk factors are present: child care attendance, school-aged siblings, exposure to environmental air pollutants, congenital abnormalities of the airways, or severe neuromuscular disease
• Infants and children younger than 2 years with cyanotic or complicated congenital heart disease
• Infants and children younger than 2 years who have been treated for chronic lung disease within 6 months of the start of the RSV season.

The most recent edition of the American Academy of Pediatrics Red Book should be consulted for more specific and latest recommendations.

Others at risk for severe illness due to RSV infection

Increasingly, RSV infection is recognized as an important cause of respiratory illness in high-risk adults and the elderly. High-risk adults include those with chronic heart disease, chronic lung disease, or compromised immune systems; the elderly include those 65 or older, particularly if they reside in a long-term care facility or participate in other senior day-care programs.