Inadvertent administration of adult RSV vaccines to infants
There have been a number of recent notifications of inadvertent administration of the adult RSV vaccine Abrysvo to infants in Victoria.
RSV vaccines, such as Abrsyvo and Arexvy, are not licensed for use in children. The safety and efficacy of these products in children has not been established. The only RSV prevention products recommended for eligible infants/young children are monoclonal antibody products, such as nirsevimab (Beyfortus). Current recommendations are for infants who have inadvertently received an RSV vaccine in error to be monitored for adverse events, and to receive a dose of nirsevimab.
Inadvertent administration of Arexvy in pregnancy
There have also been multiple notifications of inadvertent administration of Arexvy in pregnancy in Victoria.
Arexvy is not licensed for use in pregnancy, and there is limited data regarding its safety and efficacy in pregnancy. The only RSV vaccine recommended for use in pregnancy is Abrysvo, which is recommended between 28-36 weeks gestation. Current recommendations for women who have inadvertently received Arexvy in pregnancy do not recommend a follow up dose of Abrysvo within the same pregnancy. Nirsevimab may be considered for the infant.
Vaccine administration errors are preventable
Practices and immunisers should take appropriate steps to prevent errors, particularly in the context of a relatively new immunisation program. In the event of an error, the vaccinee or guardian should be informed via an open disclosure discussion. The error should also be reported to the jurisdiction’s vaccine safety service (SAEFVIC in Victoria).
All doses of RSV vaccines and nirsevimab should be reported to the Australian Immunisation Register (AIR).
Further info
- Victorian Department of Health: Respiratory syncytial virus (RSV) immunisation
- MVEC: Respiratory syncytial virus (RSV)
- MVEC: Vaccine errors: prevention, management and open disclosure (eLearning course)
- Moro PL, Scheffey A, Gallego R, et al. Incorrect Administration of Adult RSV Vaccines to Young Children. Pediatrics. 2024 May 9;153(6):e2024066174. doi: 10.1542/peds.2024-066174
- Moro PL, Gallego R, Scheffey A, et al. Administration of the GSK Respiratory Syncytial Virus Vaccine to Pregnant Persons in Error. Obstet Gynecol. 2024 May 1;143(5):704-706