Clinical Decision Aid for nirsevimab (Beyfortus) in infants and children 7 months up to 24 months of age who remain at risk of severe RSV disease

 

​Decision aid to determine if an infant or child aged 7 months up to 24 months of age who remains at risk of severe RSV is eligible to receive nirsevimab.

For infants up to 6 months of age, refer to the Clinical decision aid for nirsevimab (Beyfortus™) in newborn infants​.

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Decision aid to determine if an infant or child up to 24 months of age who remain at risk of severe RSV is eligible to receive nirsevimab. Text alternative follows image.  

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  1. Is the infant or child aged 7 months up to 24 months of age?
    1. If yes, is the infant or child entering their second and subsequent RSV season and has it been 6 months since the last does of nirsevimab?
      1. If yes, does the infant or child have one of the following risk conditions:
        • ​Preterm birth <32 weeks gestational age​​
        • Haemodynamically significant congenital heart disease
        • Significant immunosuppression, such as from solid organ transplant, haematopoietic stem cell transplant, or primary immune deficiencies such as severe combined immunodeficiency (SCID)
        • Chronic lung disease requiring ongoing oxygen or respiratory support
        • Neurological conditions that impair respiratory function
        • Cystic fibrosis with severe lung disease or weight for length <10th percentile
        • Trisomy 21 or another genetic condition that increases the risk of severe RSV disease
          1. ​​​​if yes, nirsevimab is recommended2. Order nirsevimab on the NSW Vaccine Centre webpage3​.​
      2. ​if no, it is not recommended they receive nirsevimab​
      3. If no, were they born from 1 OCtober 2024 to 31 December 2025 entering their first RSV season (gnenerally from March)?
        1. If yes, has the mother received the RSV vaccine during pregnancy?1​
          1. If yes, they are not elgibible and / or recommended to receive nirsevimab
          2. if no, has the infant received nirsevimab at birth?
            1. ​if yes, they are not elgible and / or recommended to receive nirsevimab
            2. if no, do they meet one of the following eligible criteria: are a premature infants born less than 37 weeks gestation OR are Aboriginal and Torres Strait Islander?
              1. if yes, nirsevimab is recommended.2Order nirsevimab on the NSW Vaccine Centre webpage​3​​
              2. if no, nirsevimab is not recommended4​, unless the infant or child has one of the following risk conditions:
                • ​Preterm birth <32 weeks gestational age​​
                • Haemodynamically significant congenital heart disease
                • Significant immunosuppression, such as from solid organ transplant, haematopoietic stem cell transplant, or primary immune deficiencies such as severe combined immunodeficiency (SCID)
                • Chronic lung disease requiring ongoing oxygen or respiratory support
                • Neurological conditions that impair respiratory function
                • Cystic fibrosis with severe lung disease or weight for length <10th percentile
                • Trisomy 21 or another genetic condition that increases the risk of severe RSV disease
                  1. ​​If yes, then nirsevimab is recommended.​2​Order nirsevimab on the NSW Vaccine Centre webpage3​​
                  2. if no, then nirsevimab is not recommended4​
    ​

    Notes

    1. Infants are not adequately protected if they are born within 2 weeks of the mother receiving Abrysvo during pregnancy.
    2. The dose of nirsevimab for infants weighing <5 kg, born during or entering their 1st RSV season, is 50 mg (0.5 mL) via intramuscular (IM) injection. The dose of nirsevimab for infants weighing ≥5 kg, born during or entering their 1st RSV season, is 100 mg (1 mL).The dose of nirsevimab for older children entering their 2nd or subsequent RSV season is 200 mg, given as 2 IM injections (2 × 1 mL of the 100 mg/mL formulation) at 2 different sites (preferably separate limbs, or separated by 2.5 cm) in the same visit. A minimum interval of 6 months is recommended between each season’s dose of nirsevimab.
    3. Eligible infants can receive nirsevimab at their general practice, Aboriginal medical service, or community health service. Primary care providers can order nirsevimab on the NSW Vaccine Centre webpage​​. Nirsevimab is funded by NSW Health and not available in the private market.
    4. For infants up to 6 months of age refer to the Clinical decision aid for nirsevimab (Beyfortus™) in newborn infants​.
    Current as at: Wednesday 26 November 2025
    Contact page owner: Immunisation