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Additional Guidance for 2023–2024 RSV Season

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The Texas Health and Human Services Commission (HHSC) has made further clarification revisions to the Synagis Standard Prior Authorization Request (HHS Form 1321) to clarify the use of Beyfortus and Abrysvo vaccines.

Managed care organizations (MCOs) must follow the criteria that are set out in the form. Learn more about respiratory syncytial virus (RSV) treatment on the Vendor Drug Program (VDP) web page.

Revisions

HHSC has made the following clarifications for the use of Beyfortus and Abrysvo:

  • Nirsevimab (Beyfortus)
    • Nirsevimab (Beyfortus) is approved as a single injection for infants born during or entering their first RSV season and for young children who are birth through 24 months of age 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)
    • RSVpreF (Abrysvo) is approved for use in pregnant individuals to protect newborns and infants in the first six 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 six days gestational age of pregnancy. Generally, upon a timely vaccination during pregnancy, full-term babies or babies who are born after 34 weeks of gestation should not need Synagis prophylaxis therapy.
    • For the 2023–2024 RSV season, babies who are 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 HHS Form 1321 and "verification is required" to the questions to ensure that the questions that are related to vaccinations are completed in full.

Email vdp-formulary@hhsc.state.tx.us with comments or questions.