Indications For Use
Premature infants: Beyfortus™(Nirsevimab)
Seasonal administration of nirsevimab should be considered for infants born at 32 weeks, 0 days or earlier gestation and who are <6 months of age at the beginning of the RSV season (i.e. must be born on or after June 1st, 2024).
Children with BPD/CLD Beyfortus™(Nirsevimab)
Seasonal administration of nirsevimab should be considered for children <24 months of age with bronchopulmonary dysplasia (BPD) / chronic lung disease (CLD) and who have required oxygen within 6 months preceding the RSV season (i.e. June 1st - November 2024), or other pulmonary disorders requiring oxygen therapy (e.g. hypoplastic lung).
Infants with Congenital Heart Disease (CHD): Beyfortus™(Nirsevimab)
Nirsevimab will be considered for children 12 months of age or younger at the start of the RSV season diagnosed with “hemodynamically significant” congenital heart disease (CHD).
The presence of hemodynamically significant CHD will be determined by a pediatric cardiologist. The IWK Children’s Heart Centre will be consulted prior to distribution of palivizumab for these requests.
Hemodynamically significant is defined as:
- Children with left to right shunts who require medication
- Children with congenital heart disease for whom surgery is pending
- Children with ongoing cyanosis
Nirsevimab is not recommended for use in children with minor or hemodynamically non-significant congenital or acquired heart disease, including:
- Small patent arterial ducts
- Small atrial septal defects
- Small ventricular septal defects (not requiring medication use and/or with no significant LA or LV dilation on echo)
- Those children with fully repaired congenital heart disease
Patients given prophylaxis for cardiac indications who subsequently undergo cardiopulmonary bypass, will be given a "post pump" dose if there is ongoing risk of RSV. Patients for whom the cardiac operation results in their no longer meeting criteria will not be given a post-pump dose.
"Other" children considered to be at high risk for complicated RSV: Beyfortus™(Nirsevimab)
The requesting physician and an Infectious Disease Specialist or Respirologist supporting the request is needed.
If physicians are unsure whether a patient is eligible, please contact the RSV coordinator at 902-470-2723 who will advise or review the request with the Pediatric Infectious Diseases Medical Advisor to the program as needed. Please provide contact information and details of the patient in your request. Examples of children who could be considered high risk are those with severe combined immunodeficiency (SCID), or severe hypotonia preventing adequate clearance of respiratory secretions. A detailed letter of support can be submitted from the requesting physician including patient history, and demographics, current drug therapy (when relevant), indication for use of the RSV product, and any other pertinent information to support the IWK medical approval.