Summary
- Nirsevimab (Beyfortus) administration for this respiratory season began Oct. 1, 2024.
- RSV vaccination (Abrysvo) is recommended for pregnant people from September through January.
- All infants whose birthing parent did not receive RSV vaccination are eligible for nirsevimab. Some toddlers at higher risk for severe disease are also eligible.
- Childhood Vaccine Program (CVP) providers must carry all Advisory Committee on Immunization Practices- (ACIP-) recommended vaccines.
- Washington State Immunization Information System (WAIIS) is experiencing a problem that causes duplication of some nirsevimab immunization records.
- Providers should strongly recommend respiratory virus and routine vaccines.
Providers should recommend and administer RSV vaccines and monoclonal antibody immunization to protect infants and toddlers.
To prevent severe RSV in infants and toddlers, Centers for Disease Control and Prevention (CDC) recommends either RSV vaccination for pregnant people or infant immunization with nirsevimab (Beyfortus) RSV monoclonal antibody. Pregnant people and their healthcare providers should discuss both options and consider patient preferences when deciding which product is best for their family.
A CDC survey showed only 33% of eligible pregnant people got RSV vaccine last season. Only 45% of infants got nirsevimab. Also, about half of pregnant people surveyed did not report receiving a provider recommendation for maternal RSV vaccine or nirsevimab for their infant.
Nirsevimab has been shown to be effective in protecting against RSV. According to CDC’s March 7, 2024 Morbidity and Mortality Weekly Report, nirsevimab demonstrated 90% effectiveness in preventing RSV-associated hospitalization among infants during their first RSV season.
RSV vaccine and immunization administration for pregnant people, infants, and toddlers
Healthcare providers should recommend and administer RSV vaccination (Abrysvo) to pregnant people from September through January (if not previously vaccinated). Abrysvo is administered as a single dose between 32- and 36-weeks gestation. If a pregnant person gets Abrysvo more than 14 days before giving birth, their baby will not need nirsevimab. This administration guide can help providers determine if a baby will need nirsevimab.
All infants whose birthing parent did not receive Abrysvo during the current pregnancy should receive nirsevimab. Additionally, toddlers (8–19 months) at increased risk for severe disease are also eligible. Healthcare providers should administer nirsevimab (Beyfortus) to eligible infants and toddlers October through March—ideally, in October if born April through September or at birth if born October through March. Current supplies of nirsevimab are adequate. Providers should order smaller amounts more frequently, as needed.
If a pregnant person received maternal RSV vaccine during a previous pregnancy, CDC does not recommend another dose of RSV vaccine. CDC continues to evaluate data to determine whether a sufficient benefit of revaccination in subsequent pregnancies exists.
RSV vaccines for older adults
RSV vaccine administration for older adults can occur any time during the year, but late summer or early fall is ideal. Older adults have 3 vaccine options: Abrysvo, Arexvy, or mRESVIA. All adults 75 years or older and adults 60 years or older with certain health conditions should get 1 dose of RSV vaccine. Eligible adults do not need annual RSV vaccination; CDC is evaluating the need for additional RSV vaccine doses, but at this time only a single dose is recommended.
Providers can administer RSV vaccine without regard to timing of other respiratory or routine vaccines.
Summary of respiratory virus vaccine and immunization timing
Childhood Vaccine Program requirements
Providers enrolled in Childhood Vaccine Program (CVP) must order all ACIP-recommended vaccines, including:
- Flu vaccine.
- COVID-19 vaccine.
- Nirsevimab (Beyfortus), if your practice serves eligible age groups.
You can order all respiratory products at any time. You do not need to wait for your assigned ordering window.
Children should get all recommended vaccines at their medical home. Infants and Vaccines for Children-eligible children cannot get vaccines at pharmacies.
Washington Immunization Information System (WAIIS) error
WAIIS is experiencing an error that causes duplication of some nirsevimab (Beyfortus) immunization records. The state’s vendor is working to solve the problem.
Do not delete a duplicate nirsevimab record in WAIIS—it will delete both records from the patient’s immunization history. If this occurs, re-adding the nirsevimab record will make both records re-appear.
Inventory tied to an affected nirsevimab record may also duplicate, subtracting 2 doses instead of 1 from your WAIIS inventory. To reconcile affected nirsevimab inventory:
- Choose Category “Administered” and Reason “Administered and not linked to a vaccine” when your physical counts are less than your WAIIS Quantity on Hand.
- Choose Category “Correction” and Reason “Correction of invalid entry” when your physical counts are higher than your WAIIS Quantity on Hand.
- If you don’t have the option to use these Categories/Reasons, contact your clinic’s WAIIS System Administrator or email waiishelpdesk@doh.wa.gov.
If you have questions or need help, email wachildhoodvaccines@doh.wa.gov or iis.training@doh.wa.gov.
Resources for providers
- RSV immunization chart, CDC.
- ACIP recommendations for the use of Pfizer RSV vaccine during pregnancy for the prevention of RSV-associated lower respiratory tract disease in infants, 2023, CDC.
- Updated ACIP recommendations for the use of RSV vaccine in adults 60 years or older, 2024, CDC.
- RSV immunization guidance for infants and young children, CDC.
- RSV vaccine guidance for pregnant people, CDC.
- RSV vaccine guidance for older adults, CDC.
- Nirsevemab visual guide, American Academy of Pediatrics (AAP).
- Nirsevimab frequently asked questions, AAP.
- Infant RSV prevention at-a-glance, CDC.