Respiratory syncytial virus (RSV) is serious – in the U.S., it’s the leading cause of infant hospitalization.
It’s also why healthcare providers celebrated the arrival of RSV vaccines and monoclonal antibody immunizations. There are several FDA-approved options now available to help protect against RSV, including vaccines and preventive antibody products. These products are recommended for different age groups and situations.
“This is a game-changer for everybody, honestly,” said Stephanie Hanson, M.D., a pediatrician at Sanford Children’s in Fargo, North Dakota.
Vaccination guidelines
RSV vaccine for pregnant people
- The American College of Obstetricians and Gynecologists recommends 1 dose of maternal RSV vaccine during weeks 32 through 36 of pregnancy, given Sept. 1 through March 1.
- If a pregnant person received an RSV vaccine during a previous pregnancy, an additional RSV vaccine is not currently recommended. Infants whose pregnant parent did not receive RSV vaccination during their current pregnancy should receive the recommended infant RSV immunization once they are born.
RSV immunization for infants and young children
- The American Academy of Pediatrics recommends 1 dose of the infant RSV immunization – a monoclonal antibody product – for all infants younger than 8 months born during or entering their first RSV season if:
- Their pregnant parent did not receive the maternal RSV vaccine during this pregnancy,
- Their pregnant parent’s RSV vaccination status is unknown, or
- The infant was born fewer than 14 days after the pregnant parent’s RSV vaccination
- AAP also recommends 1 dose of infant RSV immunization for infants and children ages 8-19 months who are at higher risk for severe RSV disease and entering their second RSV season:
- Children born prematurely (at less than 32 weeks)
- Children with congenital heart disease, heart defects or neuromuscular disorders that put them at risk for severe RSV disease
- Children with Down syndrome or other chromosomal differences placing them at higher risk of severe RSV disease
- Children with chronic lung disease of prematurity
- Children who are severely immunocompromised
- Children with cystic fibrosis
- American Indian or Alaska Native children. American Indian or Alaska Native children experience significantly higher rates of severe RSV disease and hospitalization associated with social drivers of health, with children living in rural and reservation communities most impacted.
RSV vaccine for adults
- The American Academy of Family Physicians recommends 1 dose of RSV vaccine for adults age 75 and older, and for ages 50-74 at increased risk of severe RSV.
- Adults 50-74 who are at increased risk include those who:
- Have chronic heart or lung disease
- Have certain other chronic medical conditions
- Are residents of nursing homes or other long-term care locations
- Have a weakened immune system
If you have any questions about RSV or the products above, talk to your healthcare provider.
“Just like other vaccines, this antibody treatment and this vaccine are not 100% effective at preventing RSV, but what they really do well is decrease the severity of the illness. They’re known to cause a dramatic decrease in hospitalizations,” Dr. Hanson said.
Baby’s three trips to the hospital
One person who is familiar with RSV hospitalizations is Siri Thaden, a Sanford Health nurse and manager of accreditation in Fargo. In December 2022, her son Ivar was hospitalized when he was just one month old after contracting RSV.
“He started with just some congestion and then I noticed he was not eating as well,” Thaden said. “When he started having fevers up to 105 degrees, that’s when I knew I had to bring him in.”
She brought Ivar to the emergency room, and after another day of labored breathing, he ended up in the intensive care unit.
“There is nothing scarier than when your child is struggling to breathe because you don’t have a lot you can do,” Thaden said. “They had him all hooked up to different things, putting high flow oxygen on him. But I knew we were in the place we needed to be.”
Ivar’s RSV led to bronchiolitis, an infection that causes swelling and mucus buildup in the smaller airways of the lung, which can be dangerous in infants.
“(Infants) have less ability to compensate,” said Dr. Hanson. “So if they get plugged up with mucus, it’s hard for them to eat. It’s hard for them to breathe. They get dehydrated. They really struggle.”
That wasn’t the end of the health scares for the Thaden family though. After five healthy months, Ivar once again contracted RSV in the spring, sending him to the hospital on Memorial Day weekend. Then it happened a third time in mid-June, when he spent five days at Sanford Children’s.
“I just really felt defeated as a mom,” Thaden said. “You just kind of ask yourself as a parent, ‘What am I doing wrong?’ To have so little control … it’s the worst feeling.”
Thaden says she’s thankful the new RSV treatment available, so that other babies can avoid what happened to Ivar.
“I am just so filled with hope and so grateful that is an option,” she said. “For me, seeing how devastating RSV was for my little boy … I don’t want that for any parent.”
Where to get RSV vaccine
RSV vaccines and antibody immunizations are available at Sanford Health clinics near you.
Find more information about immunizations at Sanford Health.
Learn more
- Is it a cold or RSV? Know when to call your child’s doctor
- What is RSV and how can you prepare?
- Small-town care was ready when baby needed it
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Posted In Children's, Emergency Medicine, Family Medicine, Immunizations
