Palivizumab Prophylaxis in Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection.

Guidance from the American Academy of Pediatrics (AAP) for the use of palivizumab prophylaxis against respiratory syncytial virus (RSV) was first published in a policy statement in 1998. AAP recommendations have been updated periodically to reflect the most recent literature regarding children at greatest risk of severe RSV disease. Since the last update in 2014, which refined prophylaxis guidance to focus on those children at greatest risk, data have become available regarding the seasonality of RSV circulation, the incidence and risk factors associated with bronchiolitis hospitalizations, and the potential effects of the implementation of prophylaxis recommendations on hospitalization rates of children with RSV infection. This technical report summarizes the literature review by the Committee on Infectious Diseases, supporting the reaffirmation of the 2014 AAP policy statement on palivizumab prophylaxis among infants and young children at increased risk of hospitalization for RSV infection. Review of publications since 2014 did not support a change in recommendations for palivizumab prophylaxis and continues to endorse the guidance provided in the 2021 Red Book.
Competing Interests: FINANCIAL/CONFLICT OF INTEREST DISCLOSURE: Dr Munoz has disclosed data safety monitoring board relationships with Pfizer and Moderna for RSV vaccine, a data safety monitor board relationship with Moderna for vaccines inclusive of RSV and COVID-19, and consultant relationships with Sanofi and Aztra-Zeneca for RSV monoclonal antibody products. Her consultant relationships with Sanofi and Aztra-Zeneca initiated after her involvement with the writing of this technical report. An independent bias review of this document did not determine any concerns for bias.
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