Synagis for RSV

Although the flu and flu shots get most of the attention in the fall and winter, parents of high risk children shouldn't forget to consider Synagis shots to prevent RSV infections through the winter RSV season.

While RSV, or the respiratory syncytial virus, may just cause a cold in older children, it can cause a serious and life threatening infection in younger high risk children. These children, including premature babies, can develop bronchiolitis, which is associated with inflammation in the lungs, wheezing and difficulty breathing. RSV can also cause croup, ear infections, and pneumonia.

Children who are considered high risk for RSV infections and who should get monthly Synagis shots during RSV season, which typically lasts from November through April, include:

1) Infants and children under age 2 years who have required treatment for chronic lung disease, such as oxygen, bronchodilators, diuretics, or steroids, within 6 months of the start of RSV season.

2) Infants born at or before 28 weeks gestation and who are less than 12 months old at the start of RSV season, which means that these preemies will need Synagis for at least one RSV season.

3) Infants born at 29 to 32 weeks, 0 days gestation and who are less than 6 months old at the start of RSV season.

4) Infants born at 32 weeks, 1 day to 35 weeks gestation and who are less than 6 months old at the start of RSV season AND who have 2 or more of the following risk factors:

• child care attendance (daycare)
• school-aged siblings
• exposure to environmental air pollutants, such as tobacco smoke
• congenital abnormalities of the airways
• severe neuromuscular disease

5) Certain children who are younger than 2 years with congenital heart disease, including congestive heart failure, pulmonary hypertension, and cyanotic heart disease.

Where to Get Synagis

Because Synagis is so expensive, it is unlikely that you will be able to get your child's Synagis shots from your pediatrician. Instead, your pediatrician will probably refer you to a 'Synagis clinic' or a home health agency for the Synagis shots.

The NICU might also set up your child's Synagis shots before you leave the nursery if your child was born prematurely.

Keep in mind that it can take some time to get the Synagis shots approved by your insurance company, so start early if your child is in a high risk group and needs Synagis this RSV season.

What You Need To Know

• Once you start Synagis during an RSV season, you typically complete the season, even if your child outgrows his risk factor. For example, if your 31 week preemie started his Synagis shots when he was 5 months old in November, you wouldn't stop them in December just because he was now 6 months old. If your child's risk factor was attending daycare and your child is now staying home, you might talk to your pediatrician about whether or not you needed to continue your infant's Synagis shots though.
  
  
• During a typical RSV season, kids get their last RSV shot in March, which provides protection into April. The timing of the last shot may vary though, depending on whether or not experts are still seeing a lot of children with RSV into early or late April.
  
  
• Some experts consider multiple births, crowded living conditions, family history of asthma, and low birth weight, to be additional risk factors to use when considering which 32 to 35 week preemies should get Synagis.
  
  

References:
¹American Academy of Pediatrics Policy Statement. Revised Indications for the Use of Palivizumab and Respiratory Syncytial Virus Immune Globulin Intravenous for the Prevention of Respiratory Syncytial Virus Infections. PEDIATRICS Vol. 112 No. 6 December 2003, pp. 1442-1446.