The Minnesota Department of Health Immunization Program shared the following letter with MNAAP in an effort to keep pediatricians up-to-date on the status of nirsevimab supplies:
The Centers for Disease Control and Prevention (CDC) alerted the Minnesota Department of Health (MDH) that the supply of nirsevimab cannot keep up with demand. Please review MDH’s Health Alert Network (HAN) for background information and interim CDC recommendations that apply to healthcare settings with limited nirsevimab availability during the 2023–2024 RSV season Health Advisory: Nirsevimab for RSV Prevention – Supply Issues (state.mn.us).
Background
There are now two available products to protect infants from severe lower respiratory tract infection caused by the respiratory syncytial virus (RSV):
• RSVpreF (vaccine) recommended for pregnant people who are 32 through 36 weeks gestation during September through January. Abrysvo is the only approved product for pregnant people.
• Nirsevimab (monoclonal antibody) recommended for all infants aged <8 months born during or entering their first RSV season and for some infants and children 8-19 months of age at increased risk of severe disease entering their second season.
Either product, but not both, can be chosen as a protection strategy. The Advisory Committee on Immunization Practices (ACIP) has not made a preference on either option.
Providers who care for pregnant persons should discuss the benefits and risks of both options, preferably before the pregnant person reaches 32 weeks gestation. CDC’s Options for Infant RSV Prevention At-a-Glance may be helpful. Information on the temporary shortage of nirsevimab should be considered when determining which product is best to protect the infant.
Under the Affordable Care Act, commercial payors have one year from ACIP recommendation to cover the vaccine for their members. This means your patients will need to check with their insurance to see if they have coverage for RSVpreF as the product was just recommended for use in September. Minnesota Health Care Programs (MHCPs) currently cover the product for pregnant people on their plans.
To support timely and accurate decision-making at the time of birth, please document vaccine administration or refusal in the pregnant person’s chart. If RSVpreF is administered to the pregnant person, please enter that dose into the Minnesota Immunization Information Connection (MIIC) in a timely manner. The MIIC forecaster/scheduler cannot predict or recommend the RSV vaccine for pregnant people because MIIC cannot track pregnancy status.
CDC recommends that all infants are protected against RSV through either maternal vaccination with RSVpreF or infant immunization with nirsevimab. Refer to the current RSV ACIP Vaccine Recommendations for details.
