Additional Guidance for 2023-24 Respiratory Syncytial Virus Season

Published on

HHSC made further clarification revisions to the Synagis Standard Prior Authorization Request (HHS Form 1321) to clarify the usage of Beyfortus and Abrysvo vaccines. MCOs must follow the same criteria. Learn more about RSV treatment.

  • Nirsevimab (Beyfortus)
    • This is approved as a single injection for infants born during or entering their first RSV season and young children up to 24 months who remain at risk of severe disease in their second RSV season. Generally, patients who receive Beyfortus at the beginning or any time during RSV season should not need Synagis prophylaxis therapy.
  • RSVpreF (Abrysvo)
    • This is approved for use in pregnant individuals to protect newborns and infants in the first 6 months after birth against lower respiratory tract disease (LRTD) and severe LRTD caused by RSV. Abrysvo must be administered at 32 weeks and 0 days through 36 weeks and 6 days gestational age of pregnancy. Generally, upon a timely vaccination during pregnancy, full-term babies or babies born after 34 weeks of gestation, should not need Synagis prophylaxis therapy.
    • For this RSV season, babies born before 34 weeks of gestation, may need treatment with Beyfortus or Synagis to offer full protection against RSV.
  • Beyfortus and RSVpreF (Abrysvo)
    • HHSC added "all questions must be answered" to sections I, II, and III of the form, and "verification is required" to the questions to ensure the senders will not leave the questions related to vaccinations blank.