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Nirsevimab Against Hospitalizations and Emergency Department Visits for Lower Respiratory Tract Infection in Infants:
Dewan Md Sumsuzzman1, Congjie Shi1, Joanne M Langley2
1Agent-Based Modelling Laboratory, York University, Toronto, Ontario, Canada.
JAMA Pediatrics
|December 22, 2025
Summary
Nirsevimab significantly reduced hospitalizations and emergency department visits for lower respiratory tract infections (LRTI) in infants. This monoclonal antibody shows promise in decreasing respiratory illness and healthcare use in young children.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Public Health
Background:
- Nirsevimab, a long-acting monoclonal antibody, is available for preventing respiratory syncytial virus (RSV) lower respiratory tract infections (LRTI) in infants.
- Real-world data on nirsevimab's broader impact on infant respiratory outcomes are needed to inform immunization policies.
Purpose of the Study:
- To evaluate the real-world association between nirsevimab administration and LRTI-related hospitalizations and emergency department (ED) visits in infants.
- To assess the effectiveness of nirsevimab in routine clinical settings for preventing respiratory-related morbidity.
Main Methods:
- A systematic search of multiple databases (MEDLINE, Embase, Web of Science, Scopus, Global Health, medRxiv) was conducted for observational studies published between January 2023 and June 2025.
- Data from 15 eligible studies, including 11 in the meta-analysis (236,764 infants in the nirsevimab group and 27,522 in controls), were analyzed using random-effects meta-analysis.
- Primary outcomes included all-cause LRTI-related hospitalizations and ED visits, and RSV-LRTI-related ED visits.
Main Results:
- Nirsevimab use was associated with significantly lower odds of all-cause LRTI-related hospitalization (OR, 0.38) and LRTI-related ED visits (OR, 0.52).
- A substantial reduction was observed in RSV-LRTI-related ED visits (OR, 0.24) among nirsevimab recipients.
- No significant difference was found in all-cause hospitalizations (OR, 0.56) between nirsevimab and control groups.
Conclusions:
- Nirsevimab is associated with reduced hospitalizations and ED visits for LRTI in infants and young children in real-world settings.
- These findings support the role of nirsevimab in mitigating respiratory-related morbidity and decreasing healthcare utilization in pediatric populations.
- Nirsevimab represents a valuable tool for pediatric immunization strategies aimed at preventing severe respiratory illness.
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