In 2014, the American Academy of Pediatrics (AAP) updated their recommendations 
for palivizumab prophylaxis for children who are at high risk for severe 
respiratory syncytial virus (RSV) infection. To investigate the potential impact 
of the more restrictive 2014 criteria on the eligibility for palivizumab 
prophylaxis, we applied the 2012 and 2014 AAP recommendations for palivizumab 
prophylaxis to a multicenter cohort of 2207 US children hospitalized for 
bronchiolitis. According to the 2012 AAP recommendations, 215 children (9.7%) 
were eligible for palivizumab prophylaxis, while 140 children (6.3%) would have 
been eligible based on the 2014 updated recommendations (34.9% relative 
decrease; 95%CI: 28.5-41.7%). The decrease was largely driven by the restriction 
of eligibility to preterm infants with gestational age <29 weeks. Further 
development of and refinement of cost-effective approaches for the prevention of 
severe RSV infection are needed.