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.  

Text alternative

Flowchart describing eligibility for nirsevimab for an infant or child aged 7 to 24 months.

  1. Start: Infant or child aged 7–24 months.
  2. Question: Is the child entering their second or subsequent RSV season and has it been 6 months since the last dose of nirsevimab?
    • No: Outcome – Not eligible and/or not recommended to receive nirsevimab.
    • Yes: Proceed to risk assessment.
  3. Risk assessment: Does the infant have any 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 (e.g., severe combined immunodeficiency)
    • 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
  4. Outcome:
    • No risk conditions:Not recommended to receive nirsevimab.
    • One or more risk conditions present: Nirsevimab is recommended and funded by NSW Health, and clinicians should order nirsevimab through the NSW Vaccine Centre webpage.
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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 11 March 2026
Contact page owner: Immunisation