Table 1.

High-risk patients

Patient segment	Recommendations	Level of evidence
Early preterm (≤28 weeks, 6 days GA)	≤12 months of age	1B
Mid preterm (29 weeks GA, 0 days to 32 weeks, 6 days GA)	≤6 months of age	1B
Late preterm (33 weeks, 0 days weeks GA to 35 weeks, 0 days GA)	≤6 months of age at the start of the RSV season OR born during RSV season with at least one of the following risk factors attendance at childcare	1B
	Children <5 years of age who live permanently in the same household (including siblings)
	Exposure to environmental air pollutants
Infants and children with CLD	<12 months for all; <24 months if still receiving medications for CLD within 6 months from the beginning of the epidemic season	1B
Infants and children with hemodynamically significant CHD	<12 months for all; <24 months if still receiving medications for the cardiac condition<6 months from the beginning of the epidemic season Postoperative dose after cardio bypass	1B
Children with anatomic pulmonary abnormalities or neuromuscular disorder	<24 months may be considered for infants with impaired ability to handle respiratory secretions	3B
Immunocompromised children	<24 months may be considered for children who are profoundly immunocompromised during the RSV season	2B
Children with Down syndrome	Recommended in children with accompanying qualifying heart disease, CLD, airway clearance issues, or prematurity (<35 weeks, 0 days GA)	2B
Children with cystic fibrosis	<12 months with clinical evidence of CLD and/or nutritional compromise <24 months with manifestations of severe lung disease OR weight for length <10th percentile	2A
Special situations: If an infant receiving prophylaxis experiences a breakthrough of RSV	If an infant who is receiving prophylaxis experiences a breakthrough of RSV, the monthly prophylaxis should continue as planned until a maximum of 5 doses have been administered	3B

RSV=Respiratory syncytial virus, OR=Odds ratio, CLD=Chronic lung disease, GA=Gestational age, CHD=Congenital heart disease