Utah DHHS Update on RSV Prophylaxi

We encourage Utah healthcare providers to promote RSV prophylaxis for eligible patients (see recommendations below). Several effective RSV preventive measures
became available in 2023, but their use has been limited. Data from the Utah Department of Health and Human Services show that Utah has lower use of these
prophylaxis measures compared to most other states. This indicates a need to remove barriers to access and improve messaging to raise awareness and reduce hesitancy among patients. We also found that immunization rates were lower in rural areas compared to urban areas in Utah. In addition, most infants received the monoclonal antibody at an outpatient clinic rather than during their birth hospitalization, which shows a missed opportunity for timely protection from RSV.

As we enter our second season of widespread availability of RSV prophylaxis, we encourage providers to talk with patients about these important protective options.

Current Recommendations:

Infants:
● Infants (8 months and younger): All infants born during or entering their first RSV season (October 1-March 31) should receive one dose of the monoclonal
antibody, nirsevimab, unless their mother received the RSV vaccine more than 14 days before delivery.
● Infants and children (8-19 months old): Children at higher risk for severe RSV disease who are entering their second RSV season (October 1-March 31) should
receive one dose of nirsevimab. This includes:
○ Children with chronic lung disease due to premature birth who needed medical support (like corticosteroids, diuretics, or oxygen) in the 6 months before their second RSV season.
○ Children who are severely immunocompromised.
○ Children with cystic fibrosis who have severe lung disease or whose weight is below the 10th percentile for length.
○ Children who are American Indian or Alaska Native.

Pregnant Individuals:
● Between September and January, a single dose of the Pfizer Abrysvo RSV vaccine should be given between weeks 32 and 36 of pregnancy.
● There are currently no recommendations for repeating the vaccine in subsequent pregnancies.

Older Adults:

● Adults aged 75 and older, and adults aged 60-74 who are at higher risk of severe RSV disease, should receive 1 dose of an RSV vaccine (Pfizer Abrysvo, GSK
Arexvy, or Moderna mRESVIA), ideally before RSV season begins.
○ The CDC provides full guidance on conditions that increase the risk for severe disease. Other conditions determined by a healthcare provider may also qualify.

● The RSV vaccine is not given annually, and there is no recommendation for repeat vaccination at this time.