Resolution No. 09/23-1 

ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES 

VACCINES FOR CHILDREN PROGRAM 

VACCINES TO PREVENT RESPIRATORY SYNCYTIAL VIRUS (RSV) 

The purpose of this resolution is to (1) add an RSV vaccine for pregnant people aged <19 

years to the VFC program, and (2) update the language regarding the recommended 

vaccine schedule for nirsevimab to take into account RSV vaccine for use during 

pregnancy. 

VFC resolution —08/23-1 is repealed and replaced by the following: 

A. RSV Maternal vaccine 

Eligible Groups 

• Pregnant people aged <19 years 

Recommended Vaccination Schedule and Intervals 

• During 32 through 36 weeks gestation, with seasonal administration. This would be during 

September through January in most of the continental United States. In jurisdictions with 

seasonality that differs from most of the continental United States (e.g., those with tropical 

climates, Alaska), providers should follow state, local, or territorial guidance on timing of 

administration. 

• Either RSV vaccination during pregnancy at 32 through 36 weeks gestation or nirsevimab 

administration for infants age <8 months shortly before or during the RSV season is 

recommended to prevent RSV lower respiratory tract infection, but both products are not 

indicated for most infants. 

Recommended dosage 

Refer to product package inserts. 

Contraindications and Precautions 

Contraindications can be found in the package inserts available at: 

https://www.fda.gov/media/168889/download?attachment 

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B. RSV Monoclonal Antibody (nirsevimab) 

Eligible Groups 

• Infants aged <8 months born during or entering their first RSV season 

• Children aged 8-19 months as noted in Table 1 who are at increased risk of severe RSV 

disease and entering their second RSV season 

Table 1. Children at increased risk of severe RSV disease 

Children with chronic lung disease of prematurity who required medical support (chronic 

corticosteroid therapy, diuretic therapy, or supplemental oxygen) any time during the 6-month period 

before the start of the second RSV season 

Children with severe immunocompromise 

Children with cystic fibrosis who have manifestations of severe lung disease (previous hospitalization 

for pulmonary exacerbation in the first year of life or abnormalities on chest imaging that persist 

when stable) or weight-for-length <10th percentile 

American Indian and Alaska Native children 

Recommended Vaccination Schedule and Intervals 

The table below summarizes the immunization schedule for administering RSV monoclonal 

antibody during the first and second RSV season. 

Table 2. Immunization Schedule 

RSV 

Season 

Schedule Timing 

First 

RSV 

Season 

One dose of nirsevimab for infants aged <8 

months born during or entering their first 

RSV season whose mother did not receive 

RSV vaccine, whose mother’s receipt of 

RSV vaccine is unknown, or who was born 

within 14 days of maternal vaccination. 

Administer from beginning 

shortly before the start of the 

RSV season until the end of the 

season 

Second One dose of nirsevimab for children aged 8– 

RSV 19 months who are at increased risk of 

Season severe RSV disease and entering their 

second RSV season (see Table 1) 

• For most infants aged <8 months born during or entering their first RSV season whose 

mother received an RSV vaccine 14 or more days prior to birth, nirsevimab is not needed. 

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Adopted and Effective: September 22, 2023 

 

Nirsevimab can be considered in rare circumstances when, per the clinical judgment of the 

healthcare provider, the potential incremental benefit of administration is warranted. 

Recommended dosage 

Refer to product package inserts. 

Contraindications and Precautions 

Contraindications and Precautions can be found in the package inserts available at: 

https://www.accessdata.fda.gov/spl/data/2f08fa60-f674-432d-801b-1f9514bd9b39/2f08fa60-

f674-432d-801b-1f9514bd9b39.xml 

[If an ACIP recommendation or notice regarding RSV prevention is published within 6 months 

following this resolution, the relevant language above (except in the eligible groups sections) 

will be replaced with the language in the recommendation and incorporated by reference to the 

publication URL.] 

This document can be found on the CDC website at: 

https://www.cdc.gov/vaccines/programs/vfc/providers/resolutions.html 

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