The edition · Paediatrics
RSV season rules widen, and the second-season group grows
The AAP's technical report sets out who gets immunised and when for 2026-27. Also: GLP-1 prescribing in eight- to eleven-year-olds up 310-fold but still reaching only the least deprived, a headset that reduces anticipatory nausea before the second cycle, and the case for diagnosing functional neurological disorder on rule-in signs rather than normal scans.
The edition in brief
The American Academy of Pediatrics technical report accompanying its 2026-27 RSV policy statement sets out the rationale for immunising all infants under 8 months born during or entering their first RSV season, unless the infant already has documented protection from vaccination during pregnancy, and for immunising infants and children aged 8 through 19 months at high risk of severe RSV disease entering a second season. It synthesises epidemiology, burden, effectiveness, safety and cost-effectiveness, and covers available products, formulations and coadministration, including the evidence behind expanding the high-risk group for second-season administration. A cross-sectional study of 3,520,531 children aged 8 to 11 with obesity and without diabetes in the Epic Cosmos dataset found 0.6% had received a GLP-1 receptor agonist. Prevalent prescribing rose from 0.03% in 2019 to 9.3% in 2026, a 310-fold increase. Rates were higher at 11 years than 8 (79.5 vs 41.5 per 10,000), in girls than boys (75.9 vs 42.8), and in children with obesity-related comorbidity (188.9 per 10,000). Children with low social vulnerability were prescribed more often than those with high vulnerability (76.1 vs 49.2 per 10,000). An assessor-blinded randomised trial in 128 children aged 6 to 12 starting first chemotherapy found immersive virtual reality reduced anxiety with an effect that grew from medium to large across cycles (Cohen's d -0.67 before the first chemotherapy to -1.48 after the second, all P < 0.001), and reduced anticipatory nausea, chemotherapy-induced nausea and vomiting at several time points. A narrative review recommends emergency clinicians diagnose paediatric functional neurological disorder positively, using rule-in signs rather than negative test results, and communicate it promptly and in validating terms.
RSV immunisation for 2026-27: who is eligible, and the second-season group has been widened
Immunise all infants under 8 months entering their first RSV season unless protection from maternal vaccination is documented, and identify the widened high-risk group of 8- to 19-month-olds for a second-season dose before the season begins.
GLP-1 prescribing in eight- to eleven-year-olds: steep growth, small numbers, unequal reach
GLP-1 prescribing in 8- to 11-year-olds with obesity rose 310-fold to 2026 but still reached only 0.6%, concentrated in those with comorbidity — and, unlike the disease, in the least socially vulnerable.
A headset before chemotherapy, and the benefit grows by the second cycle
Immersive virtual reality from the first chemotherapy cycle reduced anxiety with an effect growing from medium to large by the second cycle, and cut anticipatory nausea and vomiting — cheap, low-risk, and best started before the fear is learned.
What actually needs checking at a childhood obesity review
Use the right cuff before you record a blood pressure, screen for sleep-disordered breathing and acanthosis, take hip and knee pain seriously — and ask once about weight stigma, because it decides whether the family comes back.
Functional neurological disorder: diagnose it on the signs, not on the normal scan
Diagnose paediatric functional neurological disorder positively, on rule-in signs rather than a normal scan, and tell the family on the day in language that validates the symptoms as real — the exclusion approach delays care and causes harm.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this one is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for paediatrics, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free