The American Academy of Pediatrics has broadened its guidance to include more high-risk toddlers for RSV antibody shots this winter, aiming to reduce severe illness during the peak season.
More toddlers will be eligible for an RSV antibody shot this winter after the American Academy of Pediatrics expanded its guidance to cover a wider group of children entering a second RSV season.
The move keeps the main recommendation for babies intact. According to the Centres for Disease Control and Prevention, infants under 8 months who are born during, or entering, their first RSV season should receive nirsevimab or clesrovimab unless they already have protection from maternal vaccination. The new guidance changes what happens for children aged 8 to 19 months, where the academy says a broader list of high-risk conditions now justifies protection.
That matters because eligibility is no longer based on a general sense that a child looks vulnerable. The academy now says children in their second RSV season should receive nirsevimab if they were born very preterm, have certain chronic lung or heart conditions, severe immunocompromise, Down syndrome or another chromosomal difference associated with higher risk, qualifying cystic fibrosis, or are American Indian or Alaska Native. The guidance also includes children with anatomic lung abnormalities or neuromuscular disorders that raise the risk of severe disease.
The products involved are monoclonal antibodies, not vaccines. They work by giving ready-made protection rather than prompting the body to make its own antibodies, so they act quickly but typically last for about one season. Only nirsevimab is used for the second season; clesrovimab is for first-season infants only. The academy says the second-season dose is 200 mg, given as two 100 mg injections.
Timing remains important. The CDC says babies born during RSV season should be protected within the first week of life, ideally before discharge from hospital, while infants born outside the season should be immunised shortly before it starts. For most of the continental United States, that means the period from October through March. The academy is also urging practices to identify eligible infants and toddlers in advance, rather than waiting for families to spot the change themselves.
RSV continues to be a major cause of illness in young children, with the CDC estimating that tens of thousands of children under 5 are hospitalised each year in the United States. Cost may still be a practical concern, because medical society guidance does not automatically create the same coverage rules that follow federal advisory recommendations. Still, Sarah Nosal, president of the American Academy of Family Physicians, said insurers had indicated to the medical groups that they intend to cover this season’s respiratory immunisations. Families with a child who may qualify are being advised to check with their paediatrician now, rather than waiting until the virus is already spreading.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
