The AAP's technical report for the 2026–2027 RSV season sets out the rationale behind its recommendations, synthesising epidemiology, disease burden, immunisation effectiveness, safety and cost-effectiveness.
The structure is two-layered. All infants under eight months of age born during or entering their first RSV season should be immunised, unless they have documented protection from maternal vaccination in pregnancy. Then a second layer: infants and children aged 8 through 19 months at high risk of severe RSV disease and entering their second season should also be immunised — and the report specifically presents evidence supporting an expansion of which children count as high risk for that second dose.
The report also covers the available products and formulations and how they co-administer with other routine immunisations, which is the part that determines whether any of this happens at the visit rather than at a separate appointment.
- Check maternal RSV vaccination status before giving the infant product — documented maternal protection is the stated exception, not an assumption.
- Identify second-season candidates before the season starts; the expanded high-risk criteria are the change most likely to be missed.
- Co-administration with routine immunisations is addressed — do not schedule a separate visit for it.
- This is a US recommendation. In India, nirsevimab is not part of the universal immunisation programme and availability is limited to private practice at significant cost; the maternal vaccine is likewise not in the national schedule.
- RSV bronchiolitis admissions in Indian infants peak with the monsoon rather than the northern-hemisphere winter, so a season-based schedule imported unchanged will be mistimed.
Why it matters
The second-season high-risk group has been widened, and those are the children who were previously falling outside protection.
Don't overread it
This is a technical report supporting a policy statement, not new trial data, and its schedule is built around the northern-hemisphere RSV season.
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