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Respiratory Syncytial Virus Prophylaxis With Palivizumab Is Not Associated With Improved Lung Function in Infants of

Ingmar Fortmann1, Marie-Theres Dammann1, Alexander Humberg1,2

  • 1Department of Pediatrics, University of Lübeck, Lübeck, Germany.

CHEST Pulmonary
|August 4, 2026
PubMed

Insights

Palivizumab immunoprophylaxis did not improve lung function or reduce respiratory infections in very low-birth weight infants (VLBWIs) by school age. This study found no long-term benefits for these high-risk children.

Area of Science:

  • Pediatrics
  • Neonatology
  • Pulmonology

Background:

  • Prematurity and respiratory syncytial virus (RSV) infection are key risk factors for long-term impaired lung function.
  • Very low-birth weight infants (VLBWIs) are particularly susceptible to respiratory complications.

Purpose of the Study:

  • To investigate the long-term effects of palivizumab immunoprophylaxis on lung function and bronchitis frequency in preterm infants.
  • To assess if palivizumab administration in the first year of life impacts respiratory health at 5 to 6 years of age.

Main Methods:

  • A German Neonatal Network cohort study followed VLBWIs (birth weight < 1,500 g) from 2009-2016.
  • Children receiving at least five doses of palivizumab were compared to those who did not, with analyses stratified by bronchopulmonary dysplasia (BPD) and gestational age.
  • Lung function (FVC, FEV1) and respiratory infection risk were analyzed at 5-6 years using regression models.

Main Results:

  • Of 1,986 VLBWIs, 951 (48%) received palivizumab.
  • Children with BPD had significantly lower FEV1, but palivizumab did not alter FEV1 in this group.
  • No protective effects of palivizumab were observed for other lung function endpoints or in other risk groups.

Conclusions:

  • Palivizumab immunoprophylaxis in VLBWIs is not associated with improved lung function at early school age.
  • The study found no evidence that palivizumab reduces the frequency of respiratory tract infections in this population.
  • Current immunoprophylaxis strategies may not offer sustained respiratory benefits for VLBWIs beyond infancy.
Abstract

Keywords:
immunization of preterm infantslung functionpalivizumab

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