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RSV Prophylaxis (Infant) — MRCPCH AKP MCQ

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Moderate"Pediatrics"RSV Prophylaxis (Infant)MRCPCH AKP

A healthy term newborn weighing 4.2 kg is due for discharge from a UK maternity unit in November. The pregnancy and neonatal course were uncomplicated. The infant has no chronic lung disease, haemodynamically significant congenital heart disease, immunodeficiency or other recognised risk factor for severe respiratory syncytial virus (RSV) disease. The mother did not receive RSV vaccine during pregnancy. What is the most appropriate RSV prevention strategy for this infant?

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Correct answer: A — No infant RSV prophylaxis is indicated

The correct answer is A. In the UK, the main RSV prevention strategy for infants is maternal vaccination during pregnancy. Monoclonal antibodies are offered selectively, including to infants born before 32 weeks’ gestation and to infants or young children with specified conditions conferring high risk of severe RSV disease. A healthy term infant does not become eligible solely because the mother was unvaccinated. Palivizumab is not routine prophylaxis and is a fallback only for eligible high-risk infants when long-acting monoclonal antibodies are unavailable. RSV vaccine is not given to young infants. If this infant were eligible for nirsevimab, the licensed weight-based dose would be 50 mg once because the weight is below 5 kg; however, there is no UK programme indication here.

Reference: UK Health Security Agency. RSV vaccination of pregnant women for infant protection: information for healthcare practitioners, section “Monoclonal antibody immunisation for high-risk infants”. Updated 3 June 2026. https://www.gov.uk/government/publications/respiratory-syncytial-virus-rsv-programme-information-for-healthcare-professionals/rsv-vaccination-of-pregnant-women-for-infant-protection-information-for-healthcare-practitioners