Table 3.

Considerations for Counseling Pregnant Individuals Regarding Options for Prevention of Respiratory Syncytial Virus in Infants

	RSVPreF Maternal Vaccine	Monoclonal Antibody, Nirsevimab
Relative advantages	Provides immediate protection after birth (if maternal vaccination occurred 14 d or more before birth).	Protection may last longer than maternal vaccination.
	Maternal vaccination results in a polyclonal response, which might be more resistant to potential virus mutations than a monoclonal product.	Direct antibody transfer to infant rather than passive transfer of maternal antibodies.
		No potential risk for adverse pregnancy outcomes.
Relative disadvantages	Potential risk of preterm birth and hypertensive disorders of pregnancy.	Availability may be limited during the 2023–2024 RSV season.
	Reduced antibody transfer if delivery of neonate is less than 14 d after maternal immunization or maternal immunocompromised state (eg, inadequately treated maternal HIV infection).	Requires infant injection.

HIV, human immunodeficiency virus; RSV, respiratory syncytial virus.

Modified from Fleming-Dutra KE, Jones JM, Roper LE, Prill MM, Ortega-Sanchez IR, Moulia DL, et al. Use of the Pfizer respiratory syncytial virus vaccine during pregnancy for the prevention of respiratory syncytial virus–associated lower respiratory tract disease in infants: recommendations of the advisory committee on immunization practices—United States, 2023. MMWR Morb Mortal Wkly Rep 2023;72:1115–22.³³