A 2-week-old infant whose mother had limited prenatal care is a new patient. The mother might have had RSV vaccine, but we can’t be sure. What do we do?

If you are unable to obtain prenatal records or verify receipt of maternal RSV vaccine, CDC recommends that the baby receive nirsevimab (Beyfortus, Sanofi) or clesrovimab (Enflonsia, Merck), particularly if it is shortly before or during the RSV season. Don’t forget to check the state immunization information system (IIS) for the mother’s vaccination record. RSV vaccination during a previous pregnancy does not protect through later pregnancies. If the mother received RSV vaccine during a previous pregnancy, nirsevimab or clesrovimab is indicated for this infant. It is also important to attempt to verify from the birthing facility records whether this baby received an RSV preventive antibody product prior to discharge to avoid giving an unnecessary second dose.