Two new therapies are available to help protect our youngest patients from hospitalization and serious illness resulting from RSV. These include the pediatric monoclonal antibody therapy nirsevimab (Beyfortus) and the adult maternal vaccine Abrysvo that, when administered 14 days or more prior to delivery, produces passive immunity to the neonate for the season.  

On Sept. 22, the Advisory Committee on Immunizations Practices (ACIP), the Centers for Disease Control and Prevention (CDC), and the American College of Obstetricians and Gynecologists (ACOG) endorsed the use of the Pfizer RSV vaccine, Abrysvo, in pregnant women between 32- and 36-weeks’ gestation in the months of September through January.

The division of Maternal-Fetal Medicine is recommending that all pregnant women between 32- and 36-weeks’ gestation be offered the Abrysvo vaccine from September through the end of January.

For neonates and eligible pediatric patients whose mother did not receive Abrysvo 14 days prior to birth, nirsevimab (Beyfortus) is available. However, the adequacy of supply is limited. Because of this and after extensive discussion among content experts, the following practices will be adopted at Corewell Health.  We will preserve supply to treat our anticipated volume of high-risk infants for the season.  Additional doses will be available to use in non-high-risk infants in the ambulatory setting until it is exhausted.  Our pharmacy teams are diligently working to procure additional doses, but the manufacturer is communicating that this will be limited.

In short, we will prioritize nirsevimab (Beyfortus) use as follows:

• 50 mg doses will be restricted to high-risk inpatient neonates prior to discharge.
• Encourage all other eligible pediatric patients receive nirsevimab in the ambulatory care locations including specialty clinics.
• The CDC is recommending palivizumab (Synagis) eligible children aged 8-19 months not receive nirsevimab for the 2023-2024 season and alternatively receive palivizumab.
  

Following, you will find detailed educational materials, including guidelines for identifying high-risk patients, regarding the new RSV monoclonal antibody launch for infants. This medication is available to order now. Please use this link to request doses: Beyfortus Ordering

General educational material:  Education nirsevimab (Beyfortus).pptx

INPATIENT: Beyfortus RSV Prevention Inpatient

AMBULATORY: Beyfortus RSV Prevention Ambulatory

If you have questions, please contact Margo Bowman, Senior Director of Clinical Pharmacy Services.