According to guidelines, palivizumab RSV prophylaxis is recommended during the RSV season for which group of infants?

• A. Infants born at less than or equal to 28 weeks gestation and less than 12 months of age at the start of RSV season
• B. Infants born at term with no risk factors
• C. Infants less than 12 months with chronic lung disease requiring medical therapy
• D. Infants and children less than 24 months with chronic lung disease necessitating medical therapy within 6 months prior to the RSV season

Answer: (A)

Palivizumab is given during RSV season to infants who are at the highest risk for severe RSV disease, and the most clearly defined group is those who were born very preterm and are under a year old at the start of RSV season. Infants born at or before 28 weeks gestation have particularly immature lungs and airways, so they’re most at risk for hospitalization from RSV. The guideline criteria specify that these very preterm infants should be younger than 12 months at the start of the RSV season to qualify for prophylaxis, making this group the best-defined and most consistently recommended target for palivizumab.

Term infants without risk factors do not require prophylaxis. Infants with chronic lung disease or congenital heart disease are also high risk and can qualify, but the option focusing on the very preterm group aligns most directly with the standard, widely taught criterion and is the simplest, most reliable target population during RSV season.