Optimal implementation of an Ontario nirsevimab program for respiratory syncytial virus (RSV) prophylaxis: Recommendations from a provincial RSV expert panel

In June 2024, a group of 12 experts in the respiratory syncytial virus (RSV) field representing a cross-section of healthcare provider types who treat and care for pregnant individuals and infants, assembled to discuss the implementation of a broad infant prophylaxis program with nirsevimab in Ontario. To gain insight on potential best practices founded on the experiences of other jurisdictions, the meeting comprised a review of the 2023/2024 RSV season programs in Spain, France, and the United States that implemented nirsevimab prophylaxis. The impact of nirsevimab in reducing severe RSV disease among infants during the first RSV season was assessed including the implications on hospital resources and healthcare system costs. The panel also reviewed the results of a 2024 online survey of healthcare providers in the province to gain insight into how the program should be implemented in Ontario to facilitate uptake in infants born during and before the onset of the RSV season. The resulting discussion led to panel consensus on several recommendations to help inform programmatic decisions regarding how nirsevimab should be administered to infants in Ontario to achieve optimal uptake and best protection against this potentially devastating infectious disease.