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What is the optimal RSV immunisation strategy for infants born in the RSV off-season?

Hannah C Moore1,2, Damien Foo1,3, Fiona Giannini1,4

  • 1Wesfarmers Centre for Vaccines and Infectious Diseases, The Kids Research Institute Australia, The University of Western Australia, Nedlands, Western Australia, Australia.

The Journal of Infectious Diseases
|June 5, 2026
PubMed

Insights

Infants born in spring and summer face higher risks for respiratory syncytial virus (RSV) hospitalizations. An extra nirsevimab dose for these infants could significantly reduce hospitalizations and healthcare costs.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Epidemiology

Background:

  • Respiratory Syncytial Virus (RSV) is a leading cause of infant hospitalizations.
  • Understanding age-specific and seasonal patterns of RSV hospitalizations is crucial for effective prevention strategies.

Purpose of the Study:

  • To investigate age-specific infant laboratory-confirmed RSV hospitalization rates based on birth month in Western Australia.
  • To evaluate the potential impact of nirsevimab prophylaxis on reducing RSV hospitalizations in vulnerable infant populations.

Main Methods:

  • Population-based analysis of infant hospitalization data.
  • Utilized Susceptible-Exposed-Infected-Recovered (SEIR) mathematical modeling simulations.
  • Examined hospitalization rates stratified by infant age and birth month.

Main Results:

  • RSV hospitalizations peaked in infants aged 1-3 months for those born during the RSV season.
  • Infants born in spring and summer (out-of-season births) showed peaks at 6-10 months of age.
  • Mathematical modeling indicated significant potential for hospitalization and cost reduction with targeted nirsevimab administration.

Conclusions:

  • Infants born in spring and summer are at a higher risk for RSV hospitalization at different age windows.
  • An additional nirsevimab dose for spring and summer born infants could be a targeted and effective public health intervention.
  • This strategy has the potential to significantly avert hospitalizations and reduce healthcare expenditures associated with RSV.

Keywords:
Respiratory Syncytial Virus (RSV)hospitalisationimmunisationinfantseasonality

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