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Nirsevimab and Acute Bronchiolitis Admissions in Infants Under One Year of Age

David Andina Martínez1,2, Gemma Claret Teruel3,4,5, Manuel Gijón Mediavilla6

  • 1Pediatric Emergency Department, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

Pediatric Pulmonology
|August 14, 2025
PubMed

Insights

Most hospitalized infants with bronchiolitis were healthy children over six months old, not eligible for nirsevimab. This highlights gaps in respiratory syncytial virus (RSV) prophylaxis coverage.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Spain initiated universal respiratory syncytial virus (RSV) prophylaxis with nirsevimab.
  • This intervention achieved a significant reduction (60%-80%) in bronchiolitis hospital admissions.

Purpose of the Study:

  • To characterize infants hospitalized with bronchiolitis post-nirsevimab implementation.
  • To evaluate the effectiveness of nirsevimab in a real-world setting.

Main Methods:

  • Retrospective study across 15 Spanish pediatric emergency departments.
  • Inclusion criteria: infants <12 months hospitalized with acute bronchiolitis during the 2023-2024 RSV season.

Main Results:

  • 947 infants with bronchiolitis were analyzed.
  • 20.9% were ineligible for nirsevimab (age >6 months, no comorbidities).
  • Among eligible infants, 50.3% received nirsevimab; 49.7% did not. RSV positivity was higher in unimmunized infants (86.5% vs. 42.1%). No significant difference in PICU admissions or length of stay between immunized and unimmunized infants with RSV bronchiolitis.

Conclusions:

  • Post-prophylaxis bronchiolitis admissions primarily involved healthy infants >6 months, eligible but unimmunized infants, and immunized infants with non-RSV infections.
  • Further research is required to understand outcomes for immunized infants admitted with RSV bronchiolitis.
Abstract

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