Nirsevimab Effectiveness Against Intensive Care Unit Admission for Respiratory Syncytial Virus in Infants — 24 States, December 2024–April 2025
Year: 2025
Type: article
Study design: Observational Study
Abstract: Respiratory syncytial virus (RSV) is a leading cause of intensive care unit (ICU) admission and respiratory failure among infants (children aged <1 year) in the United States. In August 2023, CDC's Advisory Committee on Immunization Practices recommended nirsevimab, a long-acting monoclonal antibody, to protect against RSV-associated lower respiratory tract infection among all infants aged <8 months born during or entering their first RSV season. Following licensure, nirsevimab effectiveness has been demonstrated against RSV-associated infant hospitalization, but evidence regarding effectiveness against RSV-associated critical illness is limited. In a 27-hospital case-control investigation, nirsevimab effectiveness against both RSV-associated infant ICU admission and acute respiratory failure (illness requiring continuous positive airway pressure, bilevel positive airway pressure, or invasive mechanical ventilation) after hospital admission was evaluated during December 1, 2024-April 15, 2025. Among 457 case-patients who received a positive RSV test result and 302 control patients who received a negative RSV test result admitted to an ICU with respiratory symptoms, 14% and 45%, respectively, had received nirsevimab ≥7 days before symptom onset. Nirsevimab was 80% effective (95% CI = 70%-86%) against RSV-associated ICU admission and 83% effective (95% CI = 74%-90%) against acute respiratory failure when received a median of 52 days (IQR = 32-89 days) and 50 days (IQR = 32-86 days) before onset for each respective endpoint. These estimates support the recommendation for use of nirsevimab as a prevention strategy to protect infants against severe outcomes from RSV infection.
Authors: Laura D. Zambrano, Regina M. Simeone, Margaret M. Newhams, Amanda B. Payne, Natasha B. Halasa, Amber O. Orzel-Lockwood, Jemima M. Calixte, Satoshi Kamidani, Hillary Crandall, Melissa A. Cameron, Jennifer E. Schuster, Aline B. Maddux, Kathleen Chiotos, Katherine Irby, Steven L. Shein, Mary Allen Staat, Lora M. Martin, Samina S. Bhumbra, Ryan A. Nofziger, Jigar C. Chauhan, Danielle M. Zerr, Shira J. Gertz, Judith A. Guzman-Cottrill, Michele Kong, Janet R. Hume, Bria M. Coates, Kelly N. Michelson, Emily R. Levy, Tamara T. Bradford, Stephanie P. Schwartz, Tracie C. Walker, Melissa S. Stockwell, Austin Biggs, Alexander H. Hogan, Katherine Lindsey, Angela P. Campbell, Adrienne G. Randolph, Overcoming RSV Investigators, Overcoming RSV Investigators, Michele Kong, Meghan Murdock, Heather Kelley, Candice Colston, Katherine Irby, Ronald C. Sanders, Masson Yates, Ashlyn Madding, Melissa A. Cameron, Michael Henne, Aline B. Maddux, Ariana Valenzuela, Natasha Baig, Lexi Petruccelli, Rachel Greer, Heidi Sauceda, Frances Zorensky, Alexander H. Hogan, Katherine Herbst, Carlie Defelice, Gretchen Blume, Jigar C. Chauhan, Scott L. Weiss, Rebecca Clifford, Jenna Lapira, Satoshi Kamidani, Mark D. Gonzalez, Caroline R. Ciric, Jong-Ha C. Choi, Gabriella Ess, Anna K. Mitchell, Luis W. Salazar, Janelle J. Spencer-Ramirez, Kelly N. Michelson, Bria M. Coates, Sarah Jae Wershil, Samina S. Bhumbra, Mary Stumpf, Tamara T. Bradford, Adrienne G. Randolph, Margaret M. Newhams, Amber O. Orzel-Lockwood, Jemima M. Calixte, Amira Toivonen, Callum Ackerman, Janet R. Hume, Emily R. Levy, Chloe A Schluttner, Carly R Crowley, Lora M., Martin, Joseph M. Majure, Lacy Malloch, Maygan Martin, Jennifer E. Schuster, Berenice Marrufo, Allison Scott, Shira J. Gertz, Elizabeth Ricciardi, Melissa S. Stockwell, Celibell Y. Vargas, Raul A. Silverio Francisco, Tom Connors, Stephanie P. Schwartz, Tracie C. Walker, Alison Mathers, Ryan A. Nofziger, Nicole Twinem, Heather Anthony, Olivia Kennedy, Mary Allen Staat, Chelsea C. Rohlfs, Steven L. Shein, Rajashri Rasal, Judith A. Guzman-Cottrill, Chelsea Heisler, Kathleen Chiotos, Jenny Bush, Alanah Mckelvey, Rebecca Douglas, Myooran Sivarupan, Glory Edioma, Taylor A. Slocumb, Austin Biggs, Zach Rusler, Natasha B. Halasa, Laura S. Stewart, Kristina A. Betters, Annika Conlee, Madeline Spradley, Adriana Blanco Vasquez, Eliana Rebolledo, Hillary Crandall, Danielle M. Zerr, Amanda Adler
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funders: Pfizer, Sanofi, Vanderbilt University, University of Minnesota, Moderna, Bavarian Nordic, Seqirus, National Institutes of Health, Centers for Disease Control and Prevention, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development
OpenAlex ID: W4416422730