Nov. 22, 2023

Health Advisory: Nirsevimab (RSV immunization) supplies only available in limited quantities

Washington is scheduled to receive 7,700 50 mg and 600 100 mg Pfizer nirsevimab doses for the remainder of respiratory syncytial virus (RSV) season. The CDC released a Health Alert that provides guidance for healthcare providers. See the background section below for details. 

ACTIONS REQUESTED

BE AWARE nirsevimab is on allocation from CDC. Washington Department of Health (DOH) is prioritizing tribal clinics and birthing hospitals.

CONSIDER encouraging pregnant people to get Abrysvo RSV vaccine at 32-36 weeks gestation to protect newborns from severe RSV after birth.

CONSIDER giving Palivizumab (Synagis) to eligible infants instead of nirsevimab this RSV season.

CONSIDER stocking Abrysvo vaccine at your clinic.

BE AWARE pharmacists can give Abrysvo to pregnant patients, as the Advisory Committee on Immunization Practices (ACIP) recommends it. Use the Abrysvo vaccine locator to find this vaccine.

Immunize.org released a standing order template for this RSV season to ensure infants meet eligibility criteria.

BACKGROUND

The state Department of Health provided the following updates: 

The release of nirsevimab, a new RSV antibody product made to reduce severe RSV illness in infants, has been limited this RSV season. CDC put nirsevimab under allocation after demand outmatched manufacturer supply. On Nov. 6, 2023, Washington received a notice from the CDC about the amount of nirsevimab doses we can expect for the remainder of the season. 

PRIORITIZING ADDITIONAL NIRSEVIMAB DOSES 

Due to the small number of additional doses the state can order, the Washington State Department of Health is prioritizing doses to provider groups as follows: 

• 100mg doses for tribal clinics 
• 50mg doses for tribal clinics and birthing hospitals 

Other provider groups may not receive additional nirsevimab doses for the rest of RSV season given the limited supply.  

CDC GUIDANCE

• CDC recommends the Abrysvo vaccine for pregnant people.
  • Administer Abrysvo vaccine during RSV season (September–January).
    • Give without regard to timing of other vaccines.
  • Administer between 32 weeks, 0 days and 36 weeks, 6 days gestation.
    • This gives infants adequate protection from RSV, if administered at least 14 days before delivery.
  • ACIP judged the benefits of vaccination outweighed risks. Efficacy against hospitalization for RSV was 48.2% during the approved dosing interval.
    • See MMWR for complete efficacy and safety information.
      
      
• Arexvy, GSK’s RSV vaccine for older adults, is not approved for use in pregnancy.

ADDITIONAL RESOURCES

CONTACTING THE HEALTH DISTRICT

Call us at 360-728-2235 and leave a message. Includes reporting notifiable conditions 24 hours a day, 7 days a week. Leave the patient’s name, date of birth and disease.

Fax us at 360-813-1168 with the same information.

This advisory is also posted on the health advisory page of our Provider Resources website, providers.kitsappublichealth.org.