Editor,—We would fully agree with Dr Sanjeev Deshpande's appraisal of the economic disadvantages of palivizumab (Arch Dis Child2000;82:88–90) and would also suggest that the financial disincentives are indeed greater than he suggests. He bases his figures on a five month course; however, a review of our figures in Rochdale,1 shows that there were significant numbers of confirmed cases of respiratory syncytial virus infection as early as September and as late as March in 1999. These results were not considered to be particularly atypical. It would therefore seem likely that to provide realistic “cover” for any baby considered sufficiently at risk, would require immunisations for at least seven months—a cost of £44 800.