Rosa M. Wong-Chew, Subdivisión de Investigación Clínica, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
María del C. Espinosa-Sotero, Servicio de Infectología, Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México
Ana E. Limón-Rojas, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
María G. Miranda-Novales, Unidad de Investigación en Análisis y Síntesis de la Evidencia, Centro Médico Nacional Siglo XXI, IMSS, Coordinación de Investigación, Instituto Mexicano del Seguro Social, Mexico City
Martha J. Avilés-Robles, Departamento de Infectología, Hospital Infantil de México Federico Gómez, Ciudad de México, México
José I. Castillo-Bejarano, Department of Pediatrics, Division of Infectious Diseases, Dr. José Eleuterio González University Hospital, Monterrey, Mexico
Sarbelio Moreno-Espinosa, Unidad de Infectología, Hospital Médica Sur, Ciudad de México, México
Rodrigo Romero-Feregrino, Adquisiciones de Insumos para la Salud, Instituto Mexicano del Seguro Social, Ciudad de México; Asociación Mexicana de Vacunología, Ciudad de México. México
Socorro A. Anzures-Gutiérrez, Servicio de Infectología, Unidad Médica de Alta Especialidad, Hospital de Gineco Pediatría 48, Instituto Mexicano del Seguro Social, León, Gto., México
Fortino Solórzano-Santos, Laboratorio de Investigación en Enfermedades Infecciosas y Parasitarias, Hospital Infantil de México Federico Gómez, Secretaría de Salud, Ciudad de México, México
Antonio Luévanos-Velázquez, Servicio de Infectología, Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud de la Universidad de Guadalajara, Jal., México
Patricia Saltigeral-Simental, Departamento de Infectología, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de México, México
Mónica Reyes-Berlanga, Delegación Guanajuato, Instituto Mexicano del Seguro Social, Gto., México
Claudia López-Enríquez, Unidad de Infectología, Hospital Español, Ciudad de México, México
Denisse N. Vaquera-Aparicio , Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Monterrey, N.L., México
Mariana Merlo-Palomera, Servicio de Infectología, Antiguo Hospital Civil de Guadalajara, Jal., México
Leticia Belmont-Martínez, Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Ciudad de México, México
Respiratory syncytial virus (RSV) is one of the leading causes of acute lower respiratory tract infection, bronchiolitis, pneumonia, and hospitalization among infants and young children, with the highest risk of severe disease observed in infants younger than six months, preterm infants, and children with bronchopulmonary dysplasia, congenital heart disease, immunocompromising conditions, and other underlying comorbidities. In Mexico, available evidence demonstrates a substantial clinical burden and a predominant seasonal circulation from September to March. In recent years, the development of novel preventive strategies has transformed the approach to RSV prevention, particularly through maternal immunization with a bivalent prefusion F protein vaccine and passive immunoprophylaxis with long-acting monoclonal antibodies. This position statement from the Mexican Academy of Pediatrics reviews the epidemiological, clinical, and real-world effectiveness evidence regarding currently available strategies for the prevention of RSV infection in the pediatric population. Maternal vaccination between 32 and 36 weeks of gestation promotes transplacental antibody transfer and provides protection to infants during the first months of life. Monoclonal antibodies, particularly nirsevimab, have demonstrated significant reductions in lower respiratory tract infection, hospitalization, intensive care unit admission, and severe RSV-associated disease, with a favorable safety profile. Based on disease burden, national seasonality, availability of preventive products, and the characteristics of the Mexican health care system, the Mexican Academy of Pediatrics proposes a complementary and progressive strategy integrating maternal vaccination and monoclonal antibody immunoprophylaxis, initially prioritizing high-risk infants and gradually expanding coverage to all susceptible infants. Implementation should consider efficacy, safety, cost-effectiveness, operational feasibility, equity, and timely access.
Keywords: Respiratory syncytial virus. Maternal vaccination. Monoclonal antibodies. Recommendations. Prevention. Infants.