During the 2025/26 season in Spain, three cases of RSV-B infection with the N201T substitution in the F protein, which confers resistance to nirsevimab, were detected in children. Two of the infected children had previously received nirsevimab, and one required intensive care. Genomic studies suggest a sporadic occurrence of these variants rather than the expansion of a single lineage. This highlights the importance of genomic surveillance and antigenic characterization for detecting variants with reduced susceptibility to antibody prevention.


