(1367) Implementation of a Nirsevimab Screening Tool in High-Risk Pediatric Patients

Introduction: Respiratory syncytial virus (RSV) is a common pediatric virus that leads to a significant number of Pediatric Intensive Care Unit (PICU) admissions annually. Previously, palivizumab was the only medication approved for prevention of severe RSV in a select patient population. In July 2023, the FDA (Food and Drug Administration) approved nirsevimab, a new long-acting human recombinant monoclonal antibody for prevention of RSV, for most infants in the United States. The supply for nirsevimab was limited. We aimed to rapidly implement a screening tool to maximize use in a vulnerable population.

Methods: Our team created a screening tool based on CDC guidance and implemented that screening tool to identify high-risk pediatric patients in the PICU and intermediate care units that qualified for nirsevimab. The age, weight, and high-risk criteria for eligibility were all used to assess patients. Patients were screened weekdays throughout RSV season. If a patient screened eligible for nirsevimab, communication was sent to the attending physician via a templated email recommending administration as clinically appropriate.

Results: During RSV season, our 3-person multidisciplinary team utilized our algorithm to screen 11,809 patients out of 11,904 possible patients. The 95 patients (0.8%) that were not screened were admitted and discharged within the weekend. Out of the 11,809 patients that were reviewed using the screening tool, consideration for administration of nirsevimab was recommended for 42 patients. In the subgroup of patients that were not screened, 7 of the 95 would have qualified.

Conclusions: Through carefully building a screening tool, screening schedule, and utilizing multidisciplinary capabilities, we were able to successfully screen for nirsevimab-eligibility in a high-risk pediatric population resulting in rapid implementation and allocation of a new preventative therapy. There is room in the future for rapid deployment of cross-disciplinary screening strategies for new drugs being offered.