Disparities in Nirsevimab Uptake Across a Pediatric Primary Care Network

Area of Science:

• Pediatric Infectious Diseases
• Public Health
• Immunization Practices

Background:

• Nirsevimab, a monoclonal antibody, was introduced for respiratory syncytial virus (RSV) prophylaxis in the 2023-2024 season.
• Understanding nirsevimab distribution is crucial for optimizing infant protection against RSV.

Purpose of the Study:

• To examine the distribution patterns of nirsevimab.
• To identify factors associated with nirsevimab receipt among eligible infants.

Main Methods:

• A cohort study was conducted in 32 pediatric primary care practices with high nirsevimab availability.
• Logistic regression analysis was used to determine factors influencing nirsevimab receipt in children under 8 months.

Main Results:

• Only 35% (2534/7208) of eligible infants received nirsevimab, with significant practice-level variation (20%-65%).
• Lower nirsevimab receipt was associated with older infant age, Black race, lower Child Opportunity Index (COI), and public insurance.

Conclusions:

• Despite near-universal availability, nirsevimab uptake was suboptimal, highlighting significant disparities.
• Factors including practice site, age, race, socioeconomic status (COI), and insurance type influenced nirsevimab receipt.
• Further research is needed to address the drivers of these disparities and improve RSV protection for all infants.