To the Editor.

Guidelines for immunoprophylaxis with RespiGam and palivizumab for prevention of respiratory syncytial virus (RSV) infection in high-risk infants and children have been issued and updated by the American Academy of Pediatrics (AAP) Committee on Infectious Diseases and Committee on Fetus and Newborn.1,2  Prais et al reported results of a survey conducted in 11 hospitals in Israel during one RSV season and noted that most of the infants admitted to the pediatric intensive care unit with a severe RSV infection were not premature, did not have chronic lung disease, and were not candidates for RSV prophylaxis as defined by the AAP guidelines. The authors concluded that, because current AAP guidelines for immunoprophylaxis will not alter RSV-induced hospitalizations significantly, “new risk-stratified guidelines for RSV prophylaxis are indicated.”

The majority of infants and children who require hospitalization due to RSV bronchiolitis or pneumonia are recognized...

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