Evaluation report
RSV Monoclonal Antibody Implementation for At-Risk Infants: Victoria, Australia's 2024 Experience.
Tuckerman J, Cheng DR, Hunter G, Elia S, Hearn T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tracked the implementation of RSV monoclonal antibody preventative treatment in five Victorian hospitals during 2024, focusing on high-risk newborns and infants. A total of 430 infants received either nirsevimab or palivizumab, with over half born prematurely. The program identified four breakthrough infections and demonstrated that targeted hospital-level programs can protect the most vulnerable infants from severe RSV disease. The findings informed Australia's broader RSV prevention strategy for 2025.
Key points
- 430 infants received RSV preventative monoclonal antibodies across five Victorian hospital sites in 2024
- 54% of recipients were premature infants, with 45% born before 32 weeks gestation
- Only four breakthrough RSV infections occurred in the cohort (2 preterm, 2 term infants)
- Targeted hospital-level programs for high-risk infants were recommended over population-wide programs due to cost-effectiveness concerns
- The 2024 implementation experience directly informed Australia's 2025 national RSV prevention program
Limitations
This was a descriptive, observational study with no formal effectiveness analysis, comparison group, or evaluation of clinical outcomes beyond breakthrough infections. The study only tracked infants at five hospital sites in one Australian state and does not provide data on long-term outcomes, safety profiles, or cost-effectiveness comparisons.
Abstract
Background New respiratory syncytial virus (RSV) preventative programs are launching globally. Our Australian jurisdiction implemented RSV monoclonal antibody provision via pediatric and perinatal hospitals for highest risk neonates and infants. The aim of this study was to monitor the implementation and utilization of nirsevimab and palivizumab in a cohort of infants at increased risk who were program recipients in Victorian hospitals in 2024 and provide evidence and operational context for future programs. Methods In this observational cohort study, suitable participants at each site were identified by checking the drug administration records for receipt of nirsevimab and/or palivizumab. Follow-up of all infants was via the hospital electronic medical record (EMR), with relevant administration information as well as any subsequent respiratory encounters (defined by testing for respiratory pathogens) at either Monash Children's Hospital or the Royal Children's Hospital, Melbourne. This study was descriptive and exploratory, and no formal effectiveness or comparative analyses were undertaken. Results In total, 430 infants received RSV preventatives at five hospital sites throughout Victoria. In total, 54% of infants who received RSV preventatives were premature (< 37 weeks gestation); 45% were < 32 weeks gestation and four infants (2 pre-term; 2 term) experienced breakthrough infection. Conclusion Without a national program combining maternal and infant preventatives, hospital-level targeted programs can protect infants at highest risk of severe RSV and reduce admissions; we recommend biopharmaceutical support for these targeted initiatives over large population-wide programs that have not met cost-effectiveness criteria-this 2024 approach informed Australia's 2025 RSV program. Findings will inform ongoing RSV special-risk initiatives.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Provision of RSV monoclonal antibodies (nirsevimab and/or palivizumab) to at-risk infants through targeted hospital-level programs
- Population
- High-risk neonates and infants (primarily premature infants <37 weeks gestation) at five Victorian hospitals
Key finding
430 infants received RSV preventatives across five Victorian hospital sites