P-485. Healthcare-associated Respiratory Syncytial Virus (RSV) Infection During Prolonged Birth Hospitalization: Is There a Role for Nirsevimab?

Abstract Background On 8/3/2023, the CDC/Advisory Committee on Immunization Practices recommended nirsevimab, a long-acting monoclonal antibody, for prevention of RSV-associated lower respiratory tract infection in all infants aged < 8 months and some high-risk young children aged 8-19 months. At Nationwide Children’s Hospital (NCH; 673 beds) and its 7 affiliated NICUs ( > 3,000 admissions/year) in Columbus, OH, infants with prolonged birth hospitalization related to prematurity or other causes receive nirsevimab shortly before hospital discharge. Earlier use of nirsevimab for prevention of healthcare-associated (HA) RSV disease was not recommended. However, HA-RSV disease is associated with substantial morbidity and occasional mortality, mainly in children with underlying medical conditions. Our objective was to determine the magnitude and review the cases of HA-RSV infections at NCH and its NICUs in order to inform guidance on timing of nirsevimab administration.Healthcare-associated RSV infections during the birth hospitalization of 18 infants and young children