02 Peacock Mat Peds RSV 508

CDC ACIP — Vaccine Advisory Committee

Acip

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Implementation and Uptake of Nirsevimab and 
Maternal Vaccine for Infant Protection from RSV
Immunization Services Division
Centers for Disease Control and Prevention
June 25, 2025National Center for Immunization and Respiratory Diseases

•National Immunization Survey (NIS):
-Random -digit -dial cellular telephone survey of adults age ≥18 years in the U.S. (all 
50 states, 5 local jurisdictions, and territories); all responses are self reported.
-Sample size: ~15,000 adult respondents weekly, ~60,000 adult respondents monthly
-Data are weighted to represent the non- institutionalized U.S. population
•Immunization Information Systems (IISs): 
-Confidential, population- based databases that record all vaccine doses administered 
by participating providers in a specific geographic area
-ISD receives monthly aggregate data for COVID, influenza, and RSV, and quarterly 
line-level, de -identified data for individual immunizations
•Vaccine Safety Datalink: 
-Estimates of vaccination coverage are based on electronic health data from multiple integrated health systemsData sources used to estimate U.S. immunization 
coverage
Coverage for Nirsevimab and Maternal 
Vaccination
Number of infants <8 months old who received nirsevimab+, by month of receipt, 
IIS data from 36 U.S. jurisdictions, October 2023– December 2024*
050000100000150000200000250000300000350000
Oct-23 Nov-23 Dec-23 Jan-24 Feb-24 Mar-24 Apr-24 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24No. of infants
Month of nirsevimab receipt
+Includes infants <8 months of age who received ≥1 dose of nirsevimab prior to January 1, 2025.​
*Preliminary IIS data through 12/31/24 from 36 U.S. jurisdictions (AK, AR, AZ, CA, CT, DC, DE, FL, IL, IA, KY, LA, MD, ME, MI,  MN, MO, MS, MT, NJ, NM, NV, NY, OH, OK, PA, SD, TN, TX, VT, WA, WI, WV, WY, NYC, Philadelphia).​
0 10000 20000 30000 40000 50000 60000Apr-23
May-23
Jun-23
Jul-23
Aug-23
Sep-23
Oct-23
Nov-23
Dec-23
Jan-24
Feb-24
Mar-24
No. infants who received nirsevimabInfant birth monthInfant age at nirsevimab receipt, by birth month 
Apr2023─Mar2024* 
0-3 days
4-6 days
7d-<1mo
>=1moAge at 
nirsevimab 
receipt
*Preliminary IIS data through 12/31/24 from 36 U.S. jurisdictions (AK, AR, AZ, CA, CT, DC, DE, FL, IL, IA, KY, LA, MD, ME, MI,  MN, MO, MS, MT, NJ, NM, NV, NY, OH, OK, PA, SD, TN, TX, VT, WA, WI, WV, WY, NYC, Philadelphia).​
0 20000 40000 60000 80000 100000Apr-24
May-24
Jun-24
Jul-24
Aug-24
Sep-24
Oct-24
Nov-24
Dec-24
No. infants who received nirsevimabInfant birth monthInfant age at nirsevimab receipt, by birth month 
Apr2024─Dec2024* 
0-3 days
4-6 days
7d-<1mo
>=1moAge at 
nirsevimab 
receipt
*Preliminary IIS data through 12/31/24 from 36 U.S. jurisdictions (AK, AR, AZ, CA, CT, DC, DE, FL, IL, IA, KY, LA, MD, ME, MI,  MN, MO, MS, MT, NJ, NM, NV, NY, OH, OK, PA, SD, TN, TX, VT, WA, WI, WV, WY, NYC, Philadelphia).​
Percent of pregnant women ages 18 –49 years vaccinated with RSV vaccine 
overall and by race and ethnicity, Vaccine Safety Datalink, 2024 –25
•38.5% of pregnant women were vaccinated overall
•Vaccination coverage ranged from 25.7% among Black, Non -Hispanic (Black) 
pregnant women to 52.6% among Asian, Non -Hispanic (Asian) pregnant 
women
Data source: Respiratory Syncytial Virus (RSV) Vaccination Coverage, Pregnant Women, United States | RSVVaxView  | CDC
0.26.7 6.914.0 14.7 12.329.938.046.146.750.4
44.7
020406080100
Oct-24 (n=268) Nov-24 (n=401) Dec-24 (n=344) Jan-25 (n=336) Feb-25 (n=368) Mar-25 (n=653)PercentProtection against RSV with maternal vaccination or nirsevimab among infants <8 
months* during the RSV season (born since April 2024), National Immunization Survey -
Fall Respiratory Virus Module
Data source: https://www.cdc.gov/rsvvaxview/dashboard/nirsevimab -coverage -infants.html  57% of infants born 
April 2024- March 2025 
were protected from RSV by maternal vaccination or receipt 
of nirsevimab.
*Born April 2024- March 2025

Birthing Hospital Enrollment in VFC to 
Facilitate Nirsevimab  Administration
•For infants born during October through March, nirsevimab should be 
administered in the first week of life – ideally during the birth 
hospitalization.1
•Children who lack commercial insurance coverage (~45%)2 are less likely to 
be seen by their primary care provider (PCP) within one week of birth than 
are children who are commercially insured.
•Birthing facilities and their staff are critical to ensuring newborns are protected against RSV before hospital discharge, including newborns who qualify for the Vaccines for Children (VFC) program.Protecting Newborns against RSV
1. Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease Among Infants and Young Children: Recommendations  of the Advisory Committee on Immunization Practices 
— United States, 2023 | MMWR
2. CDC National Center for Health Statistics: Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January –June 2024
•Participation in the VFC Program:
-Promotes equitable access to all ACIP -recommended vaccines
-Enables newborns to receive the immunizations they need before hospital 
discharge
-Reduces hospital’s up -front costs
•Hospitals do not pay for nirsevimab or hepatitis B vaccines for VFC -eligible 
children
-Helps provide quality care to all infants who are at risk for RSV infection, regardless of insurance statusBenefits for Birthing Hospitals
•2023
-292 of 2,827 (10%) birthing hospitals were 
enrolled in VFC
•Updated policy approaches, new partnerships, 
and communication
•2025*ⴕ:
-1,012 (36%) birthing hospitals are enrolled in VFC
-Substantial increase over a two -year period 
between October 2023 and March 2025Birthing Hospital Enrollment in VFC
*Data as of March 31,  2025
ⴕ  Data reported by the Provider Education Assessment and Reporting (PEAR) system
•Supply
-Anticipated to be sufficient to meet demand and to be available earlier than 
during the 2024 -2025 season 
-Earlier supply (1) enables broad availability prior to the start of immunization, (2) promotes confidence in supply and program implementation.
•Planning
-CDC will facilitate equitable availability of RSV monoclonal antibody across jurisdictions 
-Pre-season technical assistance around ordering will be provided to jurisdictions
•Increased availability of 50mg doses of nirsevimab  at the beginning of the season 
is anticipated.
•Newly licensed clesrovimab can be available once it has been added to CDC's VFC 
contracts.Supply and Ordering for RSV Monoclonal Antibody in 
the VFC program:  2025- 2026 Season
•In 2024-2025, more infants who were born during RSV season and 
received nirsevimab did so in the first month of life compared to those 
born in the prior season of administration (2023-2024).
•Maternal immunization and RSV monoclonal antibody protected 57% of 
infants born April 2024-March 2025, showing the benefit of offering both 
options. 
•Increased birthing hospital enrollment and improved early supply of RSV monoclonal antibody should provide greater access to protection from 
RSV in this upcoming season. Summary
For more information, contact CDC/ATSDR
1-800- CDC- INFO (232- 4636)
TTY:  1 -888- 232- 6348    www.cdc.gov           www.atsdr.cdc.gov 
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry.
Thank you