Palivizumab passive immunisation against respiratory syncytial virus (RSV) in at risk pre-term infants

Following recent observations of a sustained rise in rates of infections of Respiratory Syncytial Virus (RSV), it has been recommended that the palivizumab passive immunisation programme recommences.

Update This guidance was originally published on 30 June 2021 and was updated on 7 July 2022.


Palivizumab is a humanised monoclonal antibody that provides a form of passive immunisation, providing short-term protection against Respiratory Syncytial Virus (RSV). 

In the UK, RSV is a seasonal winter virus causing lower respiratory tract infections (LRTIs) usually from October to March. Most RSV infections occur in a relatively short epidemic of about 6 weeks. LRTI, resulting from RSV, usually causes mild, self-limiting illness, but may cause severe illness in vulnerable infants at high risk of LRTI resulting in hospitalisation.


Noting the atypical recent seasonal presentation of RSV an expert working group, which includes representation from Joint Committee on Vaccination and Immunisation (JCVI), the Royal College of Paediatrics and Child Health, and the UK Health Security Agency (UKHSA), has been carefully monitoring rates of RSV infection and has recommended the immediate commencement of a palivizumab passive immunisation programme. 

Infants in England, Scotland and Wales at high risk of complications from RSV infection, as defined in chapter 27a of the green book, should now be offered monthly intramuscular doses of palivizumab at a dose of 15mg/kg of body weight, for a period of up to 7 months.