PediRounds

Nirsevimab vaccine

RSV monoclonal antibody (Beyfortus) · IAP (high-risk)

When to giveHigh-risk infants only, entering their first RSV season (up to 24 mo through second season). Not universal.
Dose50 mg if body weight <5 kg; 100 mg if ≥5 kg. Second RSV season: 200 mg (2 × 100 mg). Single-dose pre-filled syringe (50 mg/0.5 mL or 100 mg/0.5 mL).
RouteIntramuscular
SiteAnterolateral aspect of thigh
Schedule / intervalSingle dose per RSV season (long-acting monoclonal antibody, not a vaccine).

Catch-up schedule

Give before onset of RSV season; a second-season dose (200 mg) for children who remain vulnerable up to 24 months.

Adverse events (AEFI)

Rash (~0.9%), injection-site reactions (~0.3%). Rare hypersensitivity. Efficacy ~75–83% vs medically-attended RSV LRTI.

Brands available in India

Beyfortus (AstraZeneca/Sanofi; marketed in India by Dr Reddy's)

Special considerations

2025 NEW — restricted to HIGH-RISK infants (prematurity <32 wk, BPD, significant CHD, severe immunocompromise, severe neuromuscular disease), after parental counselling. NOT recommended universally. Contraindicated if serious hypersensitivity to nirsevimab. Store 2–8°C (may keep 20–25°C ≤8 h).

See the full IAP-ACVIP 2025 immunisation schedule →

Sources

  • IAP-ACVIP Recommended Immunization Schedule 2025 (Indian Pediatrics 2026)
  • IAP Purple Book 2025, 5th edition