For children who are at risk for severe RSV infections, the American Academy of Pediatrics recommends immunoprophylaxis with a series of up to 5 injections of palivizumab administered monthly, beginning on November 1 of each year. However, many practitioners initiate injections at the onset of RSV season as indicated by local surveillance. This study used the model to estimate the efficacy of current regimens, including the American Academy of Pediatrics recommendation, and to design a more effective injection regimen, the optimized fixed start (OFS), which uses city-specific initiation date It found that the recommended 5-injection regimen is expected to reduce hospitalisation risk by a median of 2.7% compared with conventional regimen based on RSV surveillance.. The 5-injection OFS regimen is expected to further reduce risk by a median of 6.8 and the 4-injection OFS regimen is expected to achieve efficacy comparable to that of the conventional 5-injection regimen while reducing costs by 20%.
In the UK, the recommended dose of palivizumab is 15mg/kg of body weight, given once a month. Where possible, the first dose should be administered at the start of the RSV season (calendar week 40). Subsequent doses should be administered monthly throughout the RSV season up to a maximum of five doses.