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Nirsevimab and Hospitalization for Lower Respiratory Tract Infection During the Second Season
David Moreno-Pérez1,2,3,4, Esther Catalán-Fernández5, Borja Croche-Santander6
1Department of Health, Presidency and Emergencies, General Directorate of Public Health and Pharmaceutical Management of Andalusia, Seville, Spain.
Pediatrics
|July 27, 2026
Summary
Nirsevimab administration reduced second-season lower respiratory tract infection hospitalizations in infants. This suggests benefits extend beyond the first season, impacting long-term health and cost-effectiveness.
Area of Science:
- Pediatric infectious diseases
- Immunization and public health
Background:
- Lower respiratory tract infections (LRTI) pose a significant health burden on infants.
- Nirsevimab is a monoclonal antibody developed to protect infants against respiratory syncytial virus (RSV).
Purpose of the Study:
- To evaluate the effectiveness of nirsevimab in preventing LRTI hospitalizations during the second year of life.
- To assess the impact of early-life nirsevimab administration on subsequent respiratory illness outcomes.
Main Methods:
- A community-based case-control study involving 1375 infants across 9 pediatric hospitals.
- Infants hospitalized for LRTI in the 2024-2025 season were cases, matched with 4 community controls.
- Statistical models (IPW, AIPW) estimated the absolute risk reduction (ARR) of LRTI hospitalization associated with nirsevimab exposure.
Main Results:
- Nirsevimab administration was linked to a 17.0% absolute risk reduction in LRTI hospitalizations during the second season.
- The protective effect was more pronounced in RSV-positive infants (25.4% ARR) and those with a history of inhaler use (27.7% ARR).
- A negative control analysis confirmed the absence of significant residual confounding.
Conclusions:
- Nirsevimab administration demonstrated a significant reduction in LRTI hospitalizations during the second season of life.
- These findings indicate sustained protective benefits of nirsevimab beyond its initial administration season.
- The results have implications for understanding the long-term value and cost-effectiveness of nirsevimab in infant respiratory health.
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