Pediatrics · Infectious Disease · 2 h ago
Maternal RSV Vaccine and Nirsevimab Show Similar Protection in Full-Term Infants
A retrospective cohort study of 15,124 full-term infants born during the 2023–2025 RSV seasons found no statistically significant difference between maternal RSVpreF vaccination and infant nirsevimab in protection against RSV infection or hospitalization. Both were associated with lower rates of these outcomes than no protection.
- No significant difference between maternal RSVpreF and nirsevimab
- Both interventions were associated with fewer RSV infections
- RSV hospitalizations were uncommon in the cohort
- Observational findings do not establish equivalence
Researchers conducted a retrospective cohort study of full-term infants born during the 2023–2024 and 2024–2025 RSV seasons at Kaiser Permanente Northern California. They matched infants protected by maternal RSVpreF vaccination at 32 to 36 weeks’ gestation with infants given nirsevimab by age 7 days, and compared each group with matched infants receiving neither intervention. The primary analysis included 15,124 infants; outcomes were PCR-confirmed RSV infection and RSV-associated hospitalization from age 8 to 180 days or season end.
RSV infection occurred in 0.94% of infants in the maternal-vaccine group and 1.04% of those given nirsevimab. Hospitalization occurred in 0.06% and 0.13%, respectively. Relative product effectiveness for maternal RSVpreF versus nirsevimab was −5.3% (95% CI, −44.8% to 23.4%) against infection and 61.5% (95% CI, −10.8% to 86.7%) against hospitalization; neither difference was statistically significant. Compared with no protection, both interventions were associated with lower infection and hospitalization rates.
The findings support current US guidance offering either approach, but the observational design cannot establish equivalence or causality. Hospitalizations were uncommon, and estimates for the direct comparison were imprecise. The study included full-term infants in one integrated health system, which may limit generalizability.
In practice
For full-term infants, this cohort found no statistically significant difference in RSV infection or hospitalization between protection through maternal RSVpreF vaccination and infant nirsevimab; both were associated with lower rates of these outcomes than no protection. These findings are consistent with current US guidance allowing either approach, but do not establish that the options are equivalent. The study was observational, came from one health system, and included few hospitalizations, leaving the direct comparison imprecise.
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JAMA Network Open: Maternal Vaccination vs Nirsevimab Use and Respiratory Syncytial Virus Infection Among Full-Term Infants ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.