Bronchiolitis In Children Research Articles

Clinical practice guidelines for the management of bronchiolitis in children (2024 version)

Clinical practice guidelines for the management of bronchiolitis in children (2024 version)

Pay attention to bronchiolitis in children

Pay attention to bronchiolitis in children

Efectividad de nirsevimab en la prevención de los ingresos por bronquiolitis por virus respiratorio sincitial en lactantes

Introduction. Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of hospitalization in infants. This season, a long half-life monoclonal antibody (Nirsevimab) is available to prevent this disease for all infants born from 1 April-30 September to 2023 and all those born during RSV season (October2023- March 2024). The aim of this study was to evaluate the impact of the implementation of this antibody on RSV admissions in a tertiary hospital. Material and methods. Observational, retrospective and analytical study. All patients <6 months in October admitted for bronchiolitis at 2 time points were included: T1 or Pre-nirsevimab time: 1 September 2015-30 September 2023 and T2 or Nirsevimab time: 1 October-31 December 2023. Total admissions due to any cause of infants <6 months in the same period were used as the reference population. To assess the impact of the implementation of nirsevimab, we calculated the reduction in the percentage of admissions due to RSV with respect to total admissions in both periods, and also in the 2023-2024 season we calculated the double negative test to calculate the effectiveness of the intervention (1-Odds ratio) x 100. Results. In infants under 6 months of age, we found significant differences in the number of admissions for RSV bronchiolitis between the last season and the previous 7 seasons [574/1195 (48%) vs 6/138 (4.3%); p<0.01, RPI: 91%). In the 2023/2024 season, the effectiveness of nirsevimab in preventing admission for RSV bronchiolitis in children under 6 months of age was 85% (CI 95%: 32-97%). Conclusions. The implementation of nirsevimab has had an important impact on the number of hospital admissions for RSV bronchiolitis. There were no differences in the severity of bronchiolitis

Management of RSV Bronchiolitis in Outpatient Setting

AbstractSeasonal respiratory syncytial virus (RSV) lower respiratory infections (RSV-LRI) and bronchiolitis in children remain a high burden to medical facilities. Studies evaluating the practical approach in outpatient settings are scarce. We conducted a survey to provide an insight into management in pediatric offices in Germany. Invitations for participation in an online survey were sent to 623 providers of pediatric primary care via email. Recipients were randomly chosen from national databanks based on zip codes. The response rate was 16,2%, n=92 (14,7%) questionnaires were fully answered and analyzed. 93,5% (n=86) are board certified pediatricians. In outpatient setting, every second patient with suspected or confirmed RSV-LRI is presented three times or more. 40,7% of our participants refer less than 10% of all patients to hospital, 83,7% refer less than one third (<30%). 33,7% of all participants never perform virological testing in suspected cases of RSV-LRI. More than 50% of all participants prescribe bronchodilators, hypertonic saline inhalation is prescribed by 17,4%. Antibiotics are prescribed in less than 10% of all cases of RSV-LRI. About 3/4 ask for a clearer, more conclusive guideline regarding prophylaxis. The diagnostic approach varies significantly. Although not recommended in international guidelines, bronchodilators are still frequently used. Considering emerging options for passive immunization, broader inclusion criteria into immunization regimes are requested by the participants. More conclusive guidelines and recommendations could further improve the management of outpatient RSV-LRI in children.

Clinical Profile and Outcome of Bronchiolitis in Children With 1-24 Months of Age.

Introduction Bronchiolitis poses a significant challenge in pediatric critical care. It is an acute illness affecting the lower respiratory tract in children under the age of two. The most common cause of bronchiolitis is the seasonal respiratory syncytial virus, with influenza and adenovirus also notable contributors. It is characterized by various clinical symptoms and indicators, such as an upper respiratory prodrome, increased respiratory effort, and wheezing in younger children under two years old.This study primarily examines the clinical profile, risk factors, severity, and outcomes of bronchiolitis in children under two years, excluding the neonatal age group. Materials and methods Children under two years of age who presented with upper respiratory symptoms and their first episode of wheezing were evaluated. Those with pre-existing systemic conditions such as cardiac, respiratory, or immunodeficiency disorders were excluded. A detailed history was gathered using a questionnaire, and risk factors were analyzed. The severity of the condition was measured using the Wood-Downes-Ferres score. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States). The relationship between risk factors, severity, and outcomes was examined using the chi-squared test. A two-sided probability of p<0.05 was considered statistically significant for all tests. Results Among 54 children aged 1-24 months with bronchiolitis, the average age was 10.18 months, with a standard deviation of 4.8 months. The severity of the condition was greater in younger children (1-12 months) and tended to decrease with age. Bronchiolitis was more common in males (33 cases) than females (21 cases). Approximately 50 children (92.6%) exhibited signs of respiratory distress, and 45 children (83.3%) showed cough as an initial symptom. Severity was notably higher in children with a history of irritability, which was statistically significant (chi-squared value: 8.169; p-value: 0.017). Only 16 children (29.65%) had a history of poor feeding. Bronchiolitis was more prevalent among infants with a birth weight under 1500 grams (63%). Non-exclusive breastfeeding and early bottle feeding were significant risk factors for bronchiolitis and its severity (chi-squared values: 18.794; p-value: 0.000 and 7.795; p-value: 0.020, respectively). Only two children (3.7%) had been exposed to passive smoke, and the severity was slightly higher in these cases. There was also a statistically significant association between socioeconomic status and bronchiolitis (chi-squared value: 11.917; p-value: 0.018). Conclusion This study aims to raise awareness among parents and clinicians about the high-risk age group for bronchiolitis, its typical presentations, and predictors of severity. It underscores the impact of both biological and environmental risk factors, such as bottle feeding, non-exclusive breastfeeding, and socioeconomic status, on the severity of the condition.

Health Services Use for SARS-CoV-2-Infected Children With Croup or Bronchiolitis.

Croup and bronchiolitis are common reasons for hospitalization in children, and the role of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on utilization outcomes for these conditions is not well understood. To compare health care utilization including the rates of hospitalization, readmission, length of stay, and ICU admission for croup and bronchiolitis in children with and without evidence of concurrent SARS-CoV-2 infection over the pandemic period. This retrospective cohort study used inpatient and outpatient electronic health record data from PEDSnet institutions to examine health services use for children aged 30 days to 14 years with SARS-CoV-2 infection and diagnosed with croup or bronchiolitis. The time frame (March 2020-May 2022) was divided into predelta, delta, and omicron variant periods. Multivariable mixed effects logistic and log gamma regression models were used to calculate adjusted odds ratios for factors linked to utilization outcomes for children with versus without SARS-CoV-2 infections. Disease burden was described by variant time period. Across all time periods, among subjects with croup and bronchiolitis, 9.65% of croup patients and 3.92% of bronchiolitis patients were SARS-CoV-2-positive. The omicron variant period had the highest number of SARS-CoV-2 cases for both croup and bronchiolitis. After controlling for patient-level variables and hospital variability, we found no statistically significant differences in utilization outcomes comparing children with and without SARS-CoV-2. Pediatric patients with croup and bronchiolitis and positive SARS-CoV-2 polymerase chain reaction testing did not exhibit a significant increase in hospital and ICU admissions, which may have implications for future staffing models and public health recommendations.

Exposure to family and domestic violence in the prenatal period is associated with an increased risk of hospitalization for bronchiolitis in children under 2years.

Existing research has acknowledged a correlation between stress in pregnancy and poorer respiratory health in offspring. However, research focusing on stress caused by family and domestic violence in the prenatal period is missing. A retrospective cohort study included children born 1987-2010 who were identified as being exposed to FDV in the prenatal period (n=1477) from two sources: WA Police Information Management System and WA Hospital Morbidity Data Collection (HMDC) and a non-exposed comparison group (n=41 996). Hospitalization for bronchiolitis was identified in HMDC. Cox regression was used to estimate the adjusted and unadjusted hazard ratio and 95% confidence interval for bronchiolitis hospitalizations contact. Children exposed to FDV had a 70% (HR 1.70, 95% CI: 1.49-1.94) increased risk of hospitalization for bronchiolitis than non-exposed counterparts by age two. Children exposed to FDV had a longer average hospital stay for bronchiolitis than non-exposed children (4.0days vs. 3.8days, P<0.001). Prenatal exposure to FDV is associated with bronchiolitis hospitalization in children <2years. Along with other risk factors, clinicians should give consideration to maternal stress factors, including experiencing FDV as a potential contributor to bronchiolitis.

Effects of infant bronchiolitis on family life.

Bronchiolitis is a respiratory infection of viral origin and is often linked to syncytial respiratory virus. It is the most frequent cause of hospitalisation in children aged under 2 years and sometimes requires transfer to intensive care. Infectious complications may also arise in the short term, and longer-term progression towards asthma is also possible. The occurrence of bronchiolitis in children may affect families in different ways, and may have psychological, organisational, employment-related, and possibly financial consequences. The aim of the study was to determine the familial and socioeconomic repercussions of bronchiolitis in infants. Parents with a child with bronchiolitis between January 2021 and May 2022, who were registered at the site of the Association Française de Pédiatrie Ambulatoire (Mpedia site) or at the site of the Malin Programme, which serves families experiencing financial difficulties, were included in the study. All parents consenting to participate in the study. A total of 2,059 valid questionnaires were retrieved: 1,318 (64%) were obtained from parents through the Mpedia website and 741 (36%) were obtained through the Malin Programme. Parents associated with the Malin Programme had more children, as well as higher rates of unemployment and financial difficulties, and required greater medical assistance. Hospitalisation was necessary in 37% of cases and was comparable between groups. During the illness, moderate to severe anxiety was present in 73% of parents; this percentage rose to 87% if the child required hospitalisation. Many parents reported effects on daily home (84%) and work life (90%), and 60% had taken a leave of absence from work. Beyond the immediate or longer-term medical consequences of bronchiolitis in infants, the illness affects families in multiple ways and can lead to anxiety, as well as changes in day-to-day home and work life. Physicians should have greater awareness of these consequences and should strive to decrease their impact.

Early Impact of Nirsevimab on Ambulatory All-Cause Bronchiolitis: A Prospective Multicentric Surveillance Study in France.

After implementation of nirsevimab in 2023 in France as compared with 2022-2023, we found a 52.7%, 95% CI [46.4-58.9]) decrease in all-cause bronchiolitis in children <3 months with the lowest number of bronchiolitis cases in this population since 2017.

Presión positiva continua en las vías respiratorias (CPAP) para la bronquiolitis aguda en niños: una revisión Cochrane

Presión positiva continua en las vías respiratorias (CPAP) para la bronquiolitis aguda en niños: una revisión Cochrane

Respiratory syncytial virus subtypes in children with bronchiolitis: does it correlate with clinical severity?

BackgroundIn this retrospective study, we aimed to evaluate the factors associated with the severity of respiratory syncytial virus (RSV) bronchiolitis in children aged under 2 years who were admitted to the Children’s Hospital of Hebei between June 2018 and January 2019.MethodsSputum samples positive for RSV via multiplex PCR were subtyped using real-time PCR. Data collected included risk factors for disease severity, demographics, microbiology, and outcomes.ResultsOf the 82 children with RSV bronchiolitis, 79 were treated and discharged with improvement, while 3 died. All three patients had underlying medical conditions, including complex congenital heart disease and severe combined immunodeficiency. Further, disease severity was associated with preexisting underlying disease, fever duration, and bacterial co-infection, but not with the RSV subtype.ConclusionsOur findings suggest that an appropriate therapeutic regimen should include the detection of bacterial co-infections and the identification of underlying diseases for the effective management of severe RSV bronchiolitis.

CHANGES IN THE STATE OF IMMUNITY AT THE CELLULAR LEVEL IN PATIENTS WITH BRONCHIOLITIS

Acute bronchiolitis in children is considered one of the serious medical problems, since they occupy one of the leading places among the causes of childhood diseases. Despite numerous studies, the problem of acute bronchiolitis in frequently ill children remains unresolved, which is associated with delayed diagnosis, the peculiarities of the manifestation of clinical symptoms and laboratory data. The aim of the research is to study changes in immunity at the cellular level in patients with bronchiolitis. Materials and methods of research: to establish the relationship with immunity indicators at the cellular level, 62 patients with acute bronchiolitis were examined, divided into 2 groups: Group I - 31 patients with acute bronchiolitis in episodically ill children, group II - 31 patients with acute bronchiolitis in those who are often ill. Our study allows us to better understand the pathogenetic role of the immune status at the cellular level in the development of acute bronchiolitis in episodically ill and frequently ill children, for use in clinical practice and the development of more effective methods for predicting, diagnosing, and treating the disease

Study on transcriptome characteristics of respiratory syncytial virus bronchiolitis in children by RNA sequencing

To explore the biological characteristics related to the pathogenesis and severity of respiratory syncytial virus (RSV) bronchiolitis by RNA sequencing of white blood cells in children with RSV bronchiolitis. This study is a case-control study. A total of 87 children diagnosed with bronchiolitis and RSV antigen positive and/or RSV nucleic acid positive in the pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to April 2022 were selected as the case group. The case group was divided into three groups based on the condition: mild, moderate, and severe, and there were two groups according to the presence or absence of atopic symptoms: the atopic group and the non-atopic group, forty healthy children in the same period were selected as the control group. The whole blood leukocyte RNA of the children in the case group and the control group was extracted for RNA sequencing, and the data were analyzed to obtain differentially expressed genes (DEGs). Then, the immunobiological pathways and genes related to the pathogenesis, disease condition, and atopy were screened through Gene Ontology (GO) annotation, Kyoto Gene and Genome Encyclopedia (KEGG) annotation, and protein interaction network (PPI) construction methods. Construct the weighted gene co-expression network analysis (WGCNA) module to identify potential biological indicators related to disease severity.Compared with the control group, the case group had a total of 1 782 DEGs, including 1 586 upregulated genes and 196 downregulated genes. The GO pathway enrichment of DEGs is mainly enriched in molecular functions such as peroxidase activity and oxidoreductase activity. In the cytological components, it is mainly enriched in cytoplasmic vesicle lumen and secretory granule lumen. In biological processes, it is mainly enriched in processes such as neutrophil activation involved in immune responses, neutrophil degranulation, and neutrophil activation. KEGG analysis is mainly concentrated in the signal pathway of the viral protein interaction with cytokine and cytokine receptor. A PPI network was constructed to screen four genes at the core position, including CCL2, IL-10, MMP9 and JUN. The DEGs obtained by comparing different disease groups with the control group are mainly enriched in retrograde endocannabinoid signaling and cell apoptosis pathways. WGCNA analysis showed that the brown module related to oxygen saturation was most closely related to the disease, and its gene was mainly enriched in the RNA helicase retinoic acid inducible gene-I (RIG-I) like receptor signal pathway. There are 230 specific DEGs in the atopic group and 444 in the non-atopic group. KEGG enrichment analysis results show that both groups are enriched to NF-κB signaling pathway, the characteristic does not cause significant changes in immune response and transcriptome characteristics in children with RSV bronchiolitis. In conclusion, neutrophil activation, degranulation pathway and signal pathway of interaction between viral protein and cytokine and cytokine receptor are involved in the immune response of RSV bronchiolitis host. CCL2, IL-10, MMP9 and JUN genes may be associated with the pathogenesis. They might be potential biomarkers related to disease severity in RIG-I like receptors, cell apoptosis, and endogenous cannabinoid related signaling pathways.

Internações pediátricas por bronquiolite no Brasil: caracterização longitudinal e gastos hospitalares

Abstract Objective To assess the longitudinal distribution of the number of pediatric hospitalizations for acute viral bronchiolitis in the Brazilian Health System and the expenses with hospitalizations corresponding to each macro-region at the Brazilian national level. Methods This is a quantitative, observational, ecological study based on a retrospective and longitudinal analysis of data from the Brazilian Health System Information Technology Department from 2012 to 2021, using descriptive statistics and Tukey’s paired test. Results There was a statistically significant difference regarding hospitalization costs in macro-regions at the national level over the years (p=0.017), but Tukey’s multiple comparisons indicated that there was no significant difference between 2 consecutive years, when comparing the years 2020 and 2021 and the mean value of hospitalizations by regions. The mean proportions of the number of hospitalizations in the macro-regions in the 10 years of study were 461.1 in the Midwest, 528.27 in the North, 1,026 in the South, 1,127 in the Northeast and 3,044 in the Southeast, considering that the highest incidence in terms of the mean of hospitalization was in the Southeast and there was a statistically significant difference in the number of hospitalizations over the years (p=0.001). Conclusion There was a significant increase in the occurrence of hospitalizations for cases of acute viral bronchiolitis in children under 4 years old, especially in infants, which showed an increasing incidence of hospitalizations in this age group and hospital expenses in Brazil in most macro-regions, mainly in the Southeast.

Prevalence, Symptoms, and Treatment of Bronchiolitis and Pneumonia in Pediatric Patients

Background: Pediatric respiratory diseases, particularly pneumonia and bronchiolitis, pose significant health challenges worldwide. Understanding their prevalence, symptomatology, and effective treatment is crucial for improving pediatric health outcomes. Objective: This study aimed to investigate the occurrence, symptoms, and treatment outcomes of pneumonia and bronchiolitis in children under five years of age at the GKMC Swabi Department of Pediatrics. Methods: The study design was retrospective study, conducted from January 2022 to January 2023, at GKMC Swabi Department of Paediatrics included 100 pediatric patients diagnosed with either pneumonia (n=40) or bronchiolitis (n=60). Patients aged 0 to 10 years with respiratory symptoms indicative of these diseases were selected, excluding those with severe comorbidities or chronic respiratory disorders. Data on demographic characteristics, clinical symptoms, diagnostic test results, and treatment outcomes were collected from medical records. Diagnosis was based on clinical examination, chest Xrays, blood tests, and other relevant procedures. Descriptive statistics were used for data analysis, utilizing SPSS version 25. Results: The mean age of patients was 3.2 years (±0.5). Gender distribution was equal, with a 50/50 maletofemale ratio. Bronchiolitis and pneumonia accounted for 60% and 40% of cases, respectively. Common symptoms included cough (88%), fever (80%), and difficulty in breathing (65%). The positive treatment response was observed in 77.5% of cases, with 32.5% requiring hospitalization. The average duration of hospital stay was 5.0 days (±1.3). Secondary symptoms like wheezing (35%), chest pain (17.5%), runny nose (32.5%), and vomiting (17.5%) were also noted. Conclusion: The study highlights the significant burden of pneumonia and bronchiolitis in young children and the effectiveness of current treatment modalities. The findings emphasize the need for early recognition and treatment of these diseases, along with continued research into preventive measures and longterm outcomes. Keywords: Pediatric Respiratory Diseases, Pneumonia, Bronchiolitis, Child Health, Hospitalization, Treatment Outcomes.

Бронхиолиты у детей: серия клинических примеров

Бронхиолиты у детей: серия клинических примеров

Association of iron deficiency anemia with acute bronchiolitis in children below 2 years of age

Background: Bronchiolitis is the leading cause of respiratory distress in small children and one of the main causes of hospitalization in children &lt;2 years of age. Anemia is also identified as a risk factor for lower respiratory tract infection. Iron deficiency is considered the most common cause of anemia in developing countries. As anemia is highly prevalent in children of our country, this study was undertaken to evaluate whether iron deficiency anemia is associated with acute bronchiolitis. Method: This Cross-Sectional Analytical study was carried out in the Department of Paediatrics, Sir Salimullah Medical College Mitford Hospital (SSMCMH), Dhaka, during the period of December 2021 to November 2022 after obtaining ethical approval to explore the association between iron deficiency anemia and bronchiolitis. Hemoglobin level, RBC indices, TWBC count, serum iron, TIBC level, Transferrin saturation, and PBF were investigated and compared in all children with bronchiolitis and control. For this purpose, a total number of 71 patients were enrolled in the study and among them, 35 children with bronchiolitis were considered as cases, and 36 healthy children without bronchiolitis were considered as control, who were matched with age. After taking written informed consent from parents/legal guardians, a detailed history and thorough clinical examination and laboratory investigations were carried out on each child. Data were recorded in separate case record form and analyzed by SPSS version 23.0. Results: The mean age was found 12.1±6.7 months in cases and 14.1±6.9 months in controls. Male participants (47, 66.2%) were the predominant group in the study and female participants were (24, 33.8%). Exclusive breastfeeding was found in 10 (28.6%) cases and 25 (71.4%) controls. There was a statistically significant difference in Hb (gm/dl), MCV (fl), S.Iron (µg/dl), Transferrin Saturation (%) and RDW-CV (%) between cases and controls (p&lt;0.05). Among 35 cases, 25 (67.6%) had Iron Deficiency Anemia and statistical difference between the case and control was significant (p=0.001) with an odds ratio of 5.0. Conclusion: Iron deficiency anemia has a significant association with bronchiolitis. A larger and more extensive study was recommended.

Asthmalitis? Diagnostic Variability of Asthma and Bronchiolitis in Children

Bronchiolitis and asthma have similar acute clinical presentations in young children yet have opposing treatment recommendations. We aimed to assess the role of age and other factors in the diagnosis of bronchiolitis and asthma in children <24 months of age. We conducted a retrospective cross-sectional analysis of the Pediatric Health Information System database. We included children aged <2 years diagnosed with bronchiolitis, asthma, wheeze, or bronchospasm in emergency department or hospital encounters from 2017 to 2021. We described variation by age and between institutions. We used mixed-effects models to assess factors associated with a non-bronchiolitis diagnosis in children 12 to 23 months of age. We included 554 158 encounters from 42 hospitals. Bronchiolitis made up 98% of encounters for children <3 months of age, whereas asthma diagnoses increased with age and were included in 44% of encounters at 23 months of age. Diagnosis patterns varied widely between hospitals. In children 12 to 23 months of age, the odds of a non-bronchiolitis diagnosis increased with month of age (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.12-1.13), male sex (OR 1.37, 95% CI 1.35-1.40), non-Hispanic Black race (OR 1.54, 95% CI 1.50-1.58), number of previous encounters (OR 2.73, 95% CI 2.61-2.86, for 3 or more encounters), and previous albuterol use (OR 2.24, 95% CI 2.16-2.32). Non-bronchiolitis diagnoses and the use of inhaled bronchodilators and systemic steroids for acute wheezing respiratory illness increase with month of age in children aged 0 to 23 months. Better definitions of clinical phenotypes of bronchiolitis and asthma would allow for more appropriate treatment in acute care settings, particularly in children 12 to 23 months of age.

RSV bronchiolitis in 2018: A descriptive study of children admitted to two Johannesburg tertiary hospitals

Background. Respiratory syncytial virus (RSV) is the most common cause of severe bronchiolitis in children worldwide.Objectives. To describe clinical characteristics and outcomes of children hospitalised with bronchiolitis and to compare those with RSVbronchiolitis with children with other viral causes of bronchiolitis.Methods. A retrospective study of children admitted with virally screened bronchiolitis to Charlotte Maxeke Johannesburg AcademicHospital (CMJAH) and Nelson Mandela Children’s Hospital (NMCH) from 1 February to 31 August 2018 was conducted, where RSVpositive and -negative children were compared. These children were identified by the National Health Laboratory Service as havingundergone respiratory viral multiplex molecular assay analysis and hospital charts were retrospectively reviewed.Results. A total of 131 children admitted with bronchiolitis from CMJAH and NMCH were compared in this study, 58 from CMJAHand 73 from NMCH. In the sample group, 65 (49.6%) children had RSV in comparison with 66 (50.4%) children without RSV. Childrenwith RSV comprised 55 (42%) children with RSV only and 10 (7.6%) children with RSV in combination with another respiratory virus.Rhinovirus was the second most common virus detected in this cohort of children (n=17, 12.9%) followed by adenovirus (n=12, 9.2%)and coronavirus (n=9, 6.9%). A statistically significant risk factor noted in children requiring hospitalisation for RSV bronchiolitis wasage less than six months (p&lt;0.001).Conclusions. Bronchiolitis is a common disease in children. Respiratory syncytial virus is the most common cause of severe bronchiolitis in hospitalised infants less than six months of age.

Exacerbated lung inflammation following secondary RSV exposure is CD4+ T cell-dependent and is not mitigated in infant BALB/c mice born to PreF-vaccinated dams.

Respiratory syncytial virus (RSV) is the leading cause of childhood hospitalizations due to bronchiolitis in children under 5 years of age. Moreover, severe RSV disease requiring hospitalization is associated with the subsequent development of wheezing and asthma. Due to the young age in which viral protection is needed and risk of vaccine enhanced disease following direct infant vaccination, current approaches aim to protect young children through maternal immunization strategies that boost neutralizing maternal antibody (matAb) levels. However, there is a scarcity of studies investigating the influence of maternal immunization on secondary immune responses to RSV in the offspring or whether the subsequent development of wheezing and asthma is mitigated. Toward this goal, our lab developed a murine model of maternal RSV vaccination and repeat RSV exposure to evaluate the changes in immune response and development of exacerbated lung inflammation on secondary RSV exposure in mice born to immunized dams. Despite complete protection following primary RSV exposure, offspring born to pre-fusion F (PreF)-vaccinated dams had exaggerated secondary ILC2 and Th2 responses, characterized by enhanced production of IL-4, IL-5, and IL-13. These enhanced type 2 cellular responses were associated with exaggerated airway eosinophilia and mucus hyperproduction upon re-exposure to RSV. Importantly, depletion of CD4+ T cells led to complete amelioration of the observed type 2 pathology on secondary RSV exposure. These unanticipated results highlight the need for additional studies that look beyond primary protection to better understand how maternal immunization shapes subsequent immune responses to repeat RSV exposure.