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limited availability of Nirsevimab throughout the United States and the recent release of interim Centers for Disease Control and Prevention (CDC) recommendations to protect infants from respiratory syncytial virus (RSV) during the 2023–2024 respiratory virus season. 

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In July 2023, the Food and Drug Administration (FDA) approved 

nirsevimab (BeyfortusTM, Sanofi and AstraZeneca)

. On August 3, 2023, CDC’s Advisory Committee on Immunization Practices (ACIP) 

 nirsevimab for all infants aged <8 months who are born during or entering their first RSV season and for infants and children aged 8–19 months who are at increased risk for severe RSV disease and are entering their second RSV season.

National Respiratory and Enteric Virus Surveillance System

 (NREVSS), a national laboratory-based surveillance network, indicate RSV transmission has increased to seasonal epidemic levels in the Southern regions of the United States and is expected to continue to increase in the rest of the country within the next 1–2 months.

 a limited supply of nirsevimab, particularly the 100mg dose prefilled syringes used for infants weighing ≥5 kg. Based on manufacturing capacity and currently available stock, there are not sufficient 100mg dose prefilled syringes of nirsevimab to protect all eligible infants weighing ≥5 kg during the current RSV season. Additionally, supply of the 50mg dose prefilled syringes may be limited during the current RSV season.

Nirsevimab and the Vaccines for Children Program

Nirsevimab is available for inclusion in the Louisiana Vaccines for Children (VFC) Program. However, ordering is currently restricted due to robust demand and limited inventory at the manufacturer. CDC has informed the Louisiana Immunization Program that capped allocations will be put in place to ensure equitable distribution nationwide. The Louisiana VFC Program will alert providers when allocations have been replenished and providers can resume placing VFC orders. Facilities/providers may also receive less inventory than ordered, due to quantity restrictions during this time of limited nirsevimab supply.

Interim CDC Recommendations for Providers

In palivizumab-eligible children aged 8–19 months, suspend using nirsevimab for the 2023–2024 RSV season. These children should receive palivizumab per 

Continue offering nirsevimab to American Indian and Alaska Native children aged 8–19 months who are not palivizumab-eligible and who live in remote regions, where transporting children with severe RSV for escalation of medical care may be challenging, or in communities with known high rates of severe RSV among older infants and toddlers.

 for palivizumab-eligible infants aged <8 months when the appropriate dose of nirsevimab is not available.

Avoid using two 50mg doses for infants weighing ≥5 kilograms (≥11 pounds), because 50mg doses should be reserved only for infants weighing <5 kilograms (<11 pounds), for example those born during the season who will be at increased risk for severe RSV illness because of their young age. Furthermore, providers should be aware that some insurers may not cover the cost of two 50mg doses for an individual infant.

Providers should encourage pregnant people to receive RSVpreF vaccine (Abrysvo, Pfizer) during 32 weeks’ gestation through 36 weeks and 6 days’ gestation to prevent RSV-associated lower respiratory tract disease in infants. Only the Pfizer RSVpreF vaccine (Abrysvo) is approved and recommended for use in pregnant people. The GSK RSVpreF3 vaccine (Arexvy) should 

Either RSVpreF vaccination or nirsevimab immunization for infants is recommended to prevent RSV-associated lower respiratory tract disease in infants, but 

Additional Information for Healthcare Providers: