Table 1.

Current American Academy of Pediatrics Guidance for RSV Prophylaxis (1)

Prophylaxis (palivizumab, 15 mg/kg IM, for a maximum of 5 monthly doses) is recommended for:
1. Infants born at <29 weeks 0 days of gestation without chronic lung disease of prematurity who are younger than 12 months at the onset of RSV season.
2. Infants with chronic lung disease of prematurity younger than 24 months who continue to require medical therapy within 6 months of the onset of RSV season.
Prophylaxis may be considered for:
1. Infants younger than 12 months with hemodynamically significant heart disease or children younger than 24 months who undergo cardiac transplantation during RSV season.
2. Infants younger than 12 months with airway abnormalities or neuromuscular disorder impairing cough.
3. Children younger than 24 months old severely immunocompromised during RSV season.
Prophylaxis is not recommended for:
1. Infants born at ≥29 weeks 0 days of gestation without chronic lung disease.
2. Infants with chronic lung disease of prematurity 12 months or older who no longer require medical therapy.
3. Children who experience a breakthrough RSV hospitalization while taking palivizumab.
4. Children with Down syndrome or cystic fibrosis.
5. Children exposed to RSV in a health care facility.
Additional recommendations
• Careful hand hygiene.
• Breastfeeding.
• Elimination of tobacco smoke exposure.
• Avoidance of crowded environments.
• Limitation of group daycare activities.
  • IM=intramuscular; RSV=respiratory syncytial virus.