Update on respiratory syncytial virus hospitalizations among U.S. preterm and term infants before and after the 2014 American Academy of Pediatrics policy on immunoprophylaxis: 2011-2017.

Content Provider	Europe PMC
Author	Fergie, Jaime Goldstein, Mitchell Krilov, Leonard R. Wade, Sally W. Kong, Amanda M. Brannman, Lance
Copyright Year	2020
Abstract	Palivizumab is the only licensed respiratory syncytial virus (RSV) immunoprophylaxis (IP) available to prevent severe RSV disease in high-risk pediatric populations, including infants born at 29–34 weeks’ gestational age (wGA). In 2014, the American Academy of Pediatrics (AAP) stopped recommending RSV IP use for otherwise healthy 29–34 wGA infants and stated that 29–34 wGA infants and term infants have similar RSV hospitalization (RSVH) rates. This study aimed to compare RSV IP use and RSVH rates in 29–34 wGA infants and term infants during the 3 RSV seasons before and after the 2014 AAP policy change. RSV IP use in otherwise healthy infants 29–30, 31–32, and 33–34 wGA was estimated from pharmacy or outpatient medical claims for palivizumab. RSVH rates in the first 6 months of life were calculated per 100 infant-seasons. RSVH rate ratios were used to compare preterm infants and term infants before and after the policy change. Across infant cohorts (29–34 wGA) and chronologic age groups (<3 months and 3-<6 months), absolute decreases in RSV IP use between the combined 2011–2014 seasons and 2014–2017 seasons ranged from 7% to 38% and from 68% to 97%, respectively. Compared with 2011–2014, the RSVH risk increased 2.09-fold (P< .001) and 1.76-fold (P< .001) in 2014–2017 for infants born at 29–34 wGA and aged <6 months with commercial and Medicaid insurance, respectively. Overall, RSV IP use declined in the RSV seasons following the 2014 RSV IP policy change, and RSVH increased among 29–34 wGA infants aged <6 months.
Page Count	10
ISSN	21645515
Journal	Human Vaccines & Immunotherapeutics
Volume Number	17
PubMed Central reference number	PMC8078654
Issue Number	5
PubMed reference number	33090914
e-ISSN	2164554X
DOI	10.1080/21645515.2020.1822134
Language	English
Publisher	Taylor & Francis
Publisher Date	2020-10-22
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. © 2020 The Author(s). Published with license by Taylor & Francis Group, LLC.
Subject Keyword	RSV hospitalization RSV prevention 29-34 wGA infants high-risk infants palivizumab
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Pharmacology Immunology