Vaccine Blurbs Special Edition Issue 211: RSV Product Updates

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Washington State Department of Health | December 21, 2023

Nirsevimab Supply Use Clarifications

To our esteemed health partners,

There has been some confusion over the past few weeks about the state's nirsevimab ordering plan and when to administer nirsevimab doses to babies. As you may know, nirsevimab is an antibody product for babies used to reduce severe respiratory syncytial virus (RSV) illness. Due to high demand, there has been a nirsevimab shortage across the country. The Department of Health developed an allocation plan to ensure equitable access to this product across the state that was shared with partners in November.

It's important to fully use existing nirsevimab supply to maximize protection against RSV among infants while RSV illness continues to circulate in Washington state.

Guidelines for nirsevimab management

  • Use doses when possible, do not stockpile.
  • Use nirsevimab for any eligible baby.
  • Use the vaccine advertisement tool in the WAIIS to advertise doses you aren't using, or to search for available doses to transfer. Find directions on using the tool here.

The Centers for Disease Control and Prevention (CDC) recommends nirsevimab should be used for any eligible baby. Doses should not be saved for those at highest risk, as this may lead to unused or wasted doses. If you aren't using this product on hand or have more product than needed, please redistribute it to other clinics or facilities in need.

Aligning with this recommendation, the CDC also issued a recent health advisory alerting healthcare providers of the urgent need to administer immunizations to recommended patients for fall respiratory illnesses. This season has seen low immunization coverage for respiratory illnesses, including RSV.

Priority Groups

  • Tribal clinics
  • Birthing hospitals
  • Counties with little or no supply of nirsevimab

Nirsevimab is currently being prioritized for tribal clinics, birthing hospitals, and clinics in counties with low or no supply of nirsevimab. American Indian and Alaska Native babies are at higher risk for severe RSV illness, and birthing hospitals see the most babies eligible for nirsevimab.

Thank you for understanding

We understand this is a frustrating situation for the healthcare community. Nirsevimab is an important tool to reduce severe RSV illness in babies, and it is a difficult situation for everone when we experience a product shortage. If you have questions or concerns, please feel free to reach out to us at WAChildhoodVaccines@doh.wa.gov.


Limited Supply of Nirsevimab Available for Ordering

We have limited Beyfortus (nirsevimab) 50mg and 100 mg product available for ordering.  

We do not expect to have enough allocation to cover all requests, especially for the 100 mg product. Some orders will be adjusted or denied due to limited supply. 

Prioritization for 50 mg product continues to be for birthing hospitals, tribal health clinics, and provider clinics in counties that have yet to receive much product. Prioritization for the 100 mg product will be for provider clinics in counties with no or low supply, and tribal health clinics.  

Ordering will open this week and will remain open until supply is depleted. Place orders by January 3rd for the next shipment opportunity. Orders will be reviewed every Wednesday at 11am, until supply is no longer available.    

How do I know if I can order? 

If you see a separate RSV order set in WAIIS, you are eligible to place orders starting this week. Please keep in mind: 

  • Order by January 3rd for the next nirsevimab shipment opportunity.
  • Only order what you anticipate using for a 2-week period.
  • The 50 mg product is for infants under 11 lbs. The 100 mg product is for infants 11 lbs. or more. 
  • Please only place an order if you are ready and able to begin administering product immediately upon receipt to all eligible infants. 

As a reminder, On October 23, 2023, CDC issued a notice via the Health Alert Network recommending prioritization of limited doses of Nirsevimab in healthcare settings.  


Abrysvo Maternal RSV Vaccine Update

The Childhood Vaccine Program will have a limited supply of Abrysvo available to order this week. This maternal RSV vaccine is only for use in pregnant persons between 32-36 weeks gestation. It can be ordered in single doses. Since it is offered through the Childhood Vaccine Program it is only available for pregnant persons under 19 years of age. 

All order sets in the IIS will have this product added this week. If you have an eligible patient in your practice, please indicate this by adding a comment to your order. If there is no indication in the order regarding eligible patients, we will reach out to you to ensure the product can be used before the order will be approved. 

Thank you for your understanding.

CDC | RSV Vaccination for Pregnant People