RSV Immunization Options for Moms and Babies

Respiratory syncytial (sin-SISH-ul) virus (or “RSV”) is the leading cause of infant hospitalization in the United States. Is RSV contagious? Yes, it’s considered highly contagious because it spreads similarly to the common cold. For example, RSV can spread when someone with the virus coughs or sneezes near you or your baby. It can also spread when you or your baby touch surfaces contaminated with RSV droplets from an infected person’s cough or sneeze, and then touch your eyes, nose, or mouth without washing your hands. According to the Centers for Disease Control and Prevention, anyone can get RSV, but most people are infected for the first time as infants or toddlers. Protecting children from RSV involves exploring new immunization options for moms and babies.

Mother snuggles her little boy who is not feeling well.

What Is RSV?

RSV is a common and widespread virus. In most regions of the United States, RSV season starts during fall and peaks in the winter. RSV symptoms are usually much like colds: cough, sore throat, runny nose, congestion, and fever. RSV can also cause severe illnesses such as pneumonia and bronchiolitis, which can lead to difficulty breathing. RSV treatment isn’t usually necessary because, like a cold, the virus will get better with time. However, RSV is more serious for some populations like babies, toddlers, seniors, and people with certain chronic health conditions. That’s why so many infants and newborns are hospitalized due to severe illness from RSV every year.

Fortunately, there are new medical advances like RSV immunization that can protect children from RSV and dramatically reduce their chance of being hospitalized. Two options are a vaccine for pregnant mothers and an immunization for children under 20 months of age.

Mother helping her little child to clean nose to demonstrate possible symptom of RSV

RSV Vaccine for Pregnant Mothers

The maternal RSV vaccine (Abrysvo®) is given to pregnant mothers who are 32 to 36 weeks pregnant. Abrysvo works by allowing pregnant mothers to build an immune response (antibodies called immunoglobulins) to RSV, which is then passed along to their growing baby. If administered at least two weeks before delivery, the vaccine is effective at reducing rates of hospitalization from RSV and has also been shown to lower the number of doctor visits for RSV.

The vaccine is most effective if given during RSV season, which is typically between September and January, although some providers may have alternative recommendations based on local RSV rates. Women cannot receive the vaccine if they previously had a severe allergic reaction to any of the vaccine components. Pregnant women should discuss whether they are eligible to receive Abrysvo with their OB-GYN.

RSV Vaccine for Infants

Beyfortus® (nirsevimab-alip) is a “monoclonal antibody,” a preventive antibody that helps protect babies against serious RSV-related lung infections. This is a special kind of protein that can help the body’s immune system fight against infections. In this case, Beyfortus is an immunization designed to protect against RSV. It works differently from most vaccines by directly providing infants with an immune response to fight off the virus. Its effectiveness then declines over weeks and/or months. All infants under 8 months of age are eligible to receive Beyfortus. Here are a few other things to know:

Beyfortus is FDA-approved to help prevent serious RSV lung infections in babies.
It’s recommended by the American Academy of Pediatrics (AAP).
Beyfortus has been added to the approved immunization schedule for babies and can be given at the same time as other routine childhood vaccines.

Additionally, high risk children who are 8-19 months old and entering their second RSV season are eligible to receive a second dose of Beyfortus. Again, given during RSV season, Beyfortus is especially effective at reducing rates of hospitalization or severe illness from RSV.

How to Choose the Best Option for Your Child

Parents may find themselves asking which option is best for their newborn or infant. Most healthy newborns and infants will benefit from receiving either Abrysvo or Beyfortus. However, some patients who are at high risk of severe illness from RSV may be eligible to receive both. Parents who think their child might be high risk should discuss the best option with their primary care provider or their baby’s pediatrician.

Plan Ahead to Avoid Shortages

It may also be important to consider that there was a shortage of Beyfortus available during the 2023-24 RSV season, which limited access to the immunization for many patients and families. Parents should ask their pediatricians early in the RSV season when they can expect Beyfortus to become available. Both Abrysvo and Beyfortus are safe and effective options, so expectant mothers should start asking their OB-GYNs and pediatricians about both options now to be prepared for this upcoming RSV season.

Written by: Sara Mann, MD, MPH, a third-year pediatrics resident at Nemours Children’s Hospital, Delaware.

Many parents are breathing a sigh of relief that they can finally get their babies, toddlers, and preschoolers vaccinated against COVID-19. Two brands of the vaccine have now been authorized for children as young as 6 months old, so the little ones can now join the ranks of people ages 5 and up who have helped protect themselves. So does your young child really need a COVID-19 vaccine? After all, younger children often have milder illness when they get infected. The answer is a resounding “yes,” since many young children have had serious symptoms requiring hospitalization, and some have even died. Small children can even develop long COVID, with symptoms that bother them for a long time. Parents might also wonder why it took so long for the vaccines to be authorized for this age group. It took a long time to get the vaccines authorized for young children because […]