Information for OB-GYNS

Patient eligibility

Maternal immunization guidance³

ACOG guidelines state that clinicians should counsel patients about both the maternal RSV vaccine and monoclonal antibodies like Beyfortus.³*

Maternal RSV immunization is not recommended for infant protection under the following circumstances³:

• After January 31 during an RSV season in most of the continental United States
• If an expectant mother has already received maternal immunization during a previous pregnancy
• If expectant mothers are not within 32-36 weeks of gestation

If maternal RSV immunization is not provided, ACOG recommends that the infant receive a monoclonal antibody, such as Beyfortus, shortly after birth to protect an infant entering or born during the RSV season.³

Infants <34 weeks

Infants born at <34 weeks should receive Beyfortus, regardless of maternal vaccination status.³

Infants at risk

Infants born to mothers who have received RSV vaccination >14 days before birth may still receive Beyfortus based on clinical judgment.³

*Patient preferences for maternal vs infant immunization against RSV should be considered when deciding to administer Beyfortus.³

Regional administration guidelines

Timing of administration³

The timing of RSV vaccine administration for infant protection can vary in different jurisdictions within and outside the continental United States.

In areas with RSV seasonality differing from most of the United States, follow state, local, or territorial RSV epidemiology and guidance for the timing of immunization against RSV.

For more information about timing of immunization, see the administration schedule.

Patient eligibility

First RSV season^1,2,6,10

Infants aged <8 months born during or entering their first RSV season are recommended to receive 1 dose of Beyfortus (50 mg for infants <5 kg and 100 mg for infants ≥5 kg), based on maternal vaccine status.

• Providers should target administration shortly before the start of the season for infants aged <8 months born before their first RSV season
• For infants born shortly before or entering their first RSV season, Beyfortus should be administered within 1 week of birth, which can be during the birth hospitalization or in the outpatient setting

AAP recommends administering Beyfortus to infants in specific months during their first RSV season based on RSV seasonality.²

Second RSV season^1,2,10

Beyfortus is approved for infants and children aged 8 to 19 months at an increased risk of severe RSV disease who are entering their second RSV season (1 dose of Beyfortus [200 mg administered as 2 IM injections 2 x 100 mg]), including:

• Children with CLD of prematurity who required medical support (chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) any time during the 6-month period before the start of the second RSV season
• Severely immunocompromised children
• Children with cystic fibrosis who have either:

1. manifestations of severe lung disease (previous hospitalization for pulmonary exacerbation in the first year of life or abnormalities on chest imaging that persist when stable), or
2. weight-for-length <10th percentile

• American Indian or Alaska Native children
• Providers should target administration shortly before the start of the season for children aged 8 to 19 months who are at an increased risk of severe RSV disease

Refer to the most current AAP immunization schedule for additional immunization considerations.

Dosing & administration

Beyfortus is recommended for infants aged <8 months born during or entering their first RSV season^3,11:

• Whose mother did not receive RSV maternal vaccine or if vaccination status is unknown
• Who were born <14 days after maternal vaccination was administered
• Beyfortus may be considered for infants whose mother received the RSV maternal vaccine if, based on the clinical judgment of the healthcare provider, the potential incremental benefit of administration is warranted
• Current recommendations are if a pregnant woman has received a maternal RSV vaccine during a previous pregnancy, another dose of RSV vaccine is not recommended for subsequent pregnancies. Instead, the baby should receive a monoclonal antibody such as Beyfortus

AAP recommends administering Beyfortus to infants in specific months during their first RSV season based on RSV seasonality.²  
Refer to the most current AAP immunization schedule for additional immunization considerations.

Maternal immunization

Considerations 

Maternal immunization is not recommended in the following cases^2,4,6:

• After January in most of the continental United States^2,4
• If expectant mothers are not within 32-36 weeks of gestation^2,4
• If an expectant mother has already received maternal immunization during a previous pregnancy^2,4

Regional administration guidelines

Providers can adjust administration schedule based on local epidemiology because the timing of the onset, peak, and decline of RSV activity might vary geographically¹⁰:

• RSV seasonality in tropical climates (including Southern Florida, Guam, Hawaii, Puerto Rico, US-affiliated Pacific Islands, and US Virgin Islands) might differ
• In Alaska, RSV seasonality is less predictable, and the duration of RSV activity is often longer than the national average duration
• Providers in these jurisdictions should consult state, local, or territorial guidance on the timing of Beyfortus administration