Objectives: To describe paediatric RSV-hospitalisation trends over six seasons and changes following regional nirsevimab strategies in Italy. Methods: A Retrospective study across 19 Italian paediatric units was conducted analysing RSV-related hospitalisations in patients aged <18 years from January 2019 to March 2025. Centres were grouped by regional nirsevimab eligibility criteria (Groups A-G). Group-level ratios of 2024-2025 to pre-immunisation hospitalisations were estimated with a negative-binomial model. Influenza was analysed as a negative control RESULTS: 10,915 RSV hospitalisations were recorded. In 2024-2025 RSV season, hospitalisations decreased 43.6% overall. The largest reductions were in groups with broader eligibility and earlier initiation (Group B: ratio 0.28, 95% CI 0.22-0.36; Group A: 0.40, 95% CI 0.22-0.74) and Group F (0.24; single centre, interval indicative). Groups C, D, and E showed more modest reductions (ratios 0.58-0.70), with Group C spanning unity (0.58, 95% CI 0.27-1.25). Group G showed no clear change once baseline instability was accounted for (1.84, 95% CI 1.15-2.94). Conclusions: These population-level study describe a temporal association between the 2024-2025 nirsevimab rollout and reduced RSV hospitalisations, particularly with broader eligibility and timely rollout. The study design cannot establish causation or compare the effectiveness of regional strategies.
Heterogeneous Reduction in Paediatric RSV Hospitalisations Following Regional Nirsevimab Immunisation Strategies: A Multicentre Study / Attaianese, F., Trapani, S., Alberti, I., Aricò, M., Attanasi, M., Bertolucci, G., Bressan, S., Caselli, D., Casotto, V., Cazzato, S., Chiarelli, F., Felici, E., Frusciante, A., Galeone, M.A., Garazzino, S., Giannattasio, A., Gitto, E., Guerriero, A., Guida, F., Iudica, G., et al.. - In: INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES. - ISSN 1201-9712. - ELETTRONICO. - (2026), pp. 0-0. [10.1016/j.ijid.2026.109076]
Heterogeneous Reduction in Paediatric RSV Hospitalisations Following Regional Nirsevimab Immunisation Strategies: A Multicentre Study
Attaianese, Federica;Trapani, Sandra
;Garazzino, Silvia;Moriondo, Maria;Pellegrino, Roberta;Ricci, Silvia;Dani, Carlo;Azzari, Chiara;Indolfi, Giuseppe
2026
Abstract
Objectives: To describe paediatric RSV-hospitalisation trends over six seasons and changes following regional nirsevimab strategies in Italy. Methods: A Retrospective study across 19 Italian paediatric units was conducted analysing RSV-related hospitalisations in patients aged <18 years from January 2019 to March 2025. Centres were grouped by regional nirsevimab eligibility criteria (Groups A-G). Group-level ratios of 2024-2025 to pre-immunisation hospitalisations were estimated with a negative-binomial model. Influenza was analysed as a negative control RESULTS: 10,915 RSV hospitalisations were recorded. In 2024-2025 RSV season, hospitalisations decreased 43.6% overall. The largest reductions were in groups with broader eligibility and earlier initiation (Group B: ratio 0.28, 95% CI 0.22-0.36; Group A: 0.40, 95% CI 0.22-0.74) and Group F (0.24; single centre, interval indicative). Groups C, D, and E showed more modest reductions (ratios 0.58-0.70), with Group C spanning unity (0.58, 95% CI 0.27-1.25). Group G showed no clear change once baseline instability was accounted for (1.84, 95% CI 1.15-2.94). Conclusions: These population-level study describe a temporal association between the 2024-2025 nirsevimab rollout and reduced RSV hospitalisations, particularly with broader eligibility and timely rollout. The study design cannot establish causation or compare the effectiveness of regional strategies.
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