What is an indication for administering immunoprophylaxis against bronchiolitis in a 4-month-old infant?

Administering immunoprophylaxis against bronchiolitis, particularly with the use of palivizumab, is strongly indicated for infants who are at higher risk for severe respiratory infections due to certain medical conditions or birth histories. In this case, a 4-month-old infant who was born prematurely at 28 weeks and 4 days gestational age falls into that high-risk category.

Premature infants are more susceptible to respiratory syncytial virus (RSV), which is a common cause of bronchiolitis. Their lungs and immune systems have not fully developed, making it challenging for them to fight off infections effectively. The recommendation for immunoprophylaxis in this group is supported by clinical guidelines, which suggest that infants born before 29 weeks of gestation should receive palivizumab during the RSV season to reduce the risk of severe illness.

In contrast, although exposure to secondhand smoke and a family history of asthma may influence respiratory health, they do not constitute an indication for specific immunoprophylaxis against bronchiolitis. Additionally, a child with stable congenital heart disease requiring no surgical treatment would not be considered at the same level of risk and thus would not typically receive prophylaxis for bronchiolitis.