RSV Now Has Two Protection Paths for Babies—Here's What Parents Need to Know

Respiratory syncytial virus (RSV) was the leading cause of infant hospitalization in the United States before new immunizations became available, sending an estimated 58,000 to 80,000 children under age 5 to the hospital each year. Today, parents have two distinct ways to shield their babies from severe RSV illness, marking a significant shift in how pediatricians approach this common but potentially dangerous virus.

Why RSV Poses Such a Serious Risk to Infants?

RSV typically starts as a mild, cold-like illness with a runny nose and cough. But here's what makes it dangerous: the virus can worsen dramatically within just a few days. In very young infants under 6 months old, RSV can trigger concerning symptoms that parents might not immediately recognize as serious.

The youngest babies face the highest risk because their airways are smaller and their immune systems are still developing. Two to three out of every 100 infants under 3 months get hospitalized with RSV annually, and those admissions often require intensive support like oxygen, intravenous fluids, or even mechanical ventilation to help with breathing.

Certain groups of children face even greater danger from RSV. These vulnerable populations include:

• Age and Development: Infants and young children, with risk increasing the younger the child, face the highest hospitalization rates.
• Birth Circumstances: Children born prematurely or with chronic lung disease or congenital heart disease are at elevated risk for severe illness.
• Immune and Genetic Factors: American Indian and Alaska Native children, those with weakened immune systems, and children with severe cystic fibrosis experience disproportionately severe outcomes.
• Neurological Considerations: Children with neuromuscular disorders, especially those who have difficulty swallowing or clearing mucus secretions, face complications from RSV infection.

What Are the Early Warning Signs Parents Should Watch For?

Recognizing RSV early can help parents seek care before the illness becomes severe. In older infants and young children, watch for a runny nose, decreased eating or drinking, and a cough that may progress to wheezing or difficulty breathing.

Very young infants under 6 months show different symptoms. Instead of a typical cough, parents might notice irritability, decreased activity, reduced feeding, or pauses in breathing lasting more than 10 seconds, called apnea. Importantly, many infants with RSV won't develop a fever, which can make diagnosis trickier.

Most infants with RSV will show symptoms—unlike adults, who sometimes carry the virus without realizing it. This means if your baby has respiratory symptoms during RSV season, it's worth discussing with your pediatrician, especially if your child is in a high-risk group.

How Can Parents Protect Their Babies From Severe RSV?

The introduction of RSV immunizations represents a major breakthrough in pediatric protection. The Centers for Disease Control and Prevention (CDC) now recommends one of two approaches to prevent severe RSV illness in infants.

The first option involves an RSV vaccine given to the mother during pregnancy. This approach allows protective antibodies to transfer to the baby before birth, providing immunity from the earliest days of life. The second option is an RSV antibody given directly to infants and some older babies after they're born. This monoclonal antibody approach offers another pathway to protection for families who prefer postnatal immunization or for babies whose mothers didn't receive the vaccine during pregnancy.

Most infants who receive appropriate supportive care recover well from RSV hospitalization within a few days. However, prevention through immunization is far preferable to managing severe illness. Parents should discuss which protection option makes sense for their family with their pediatrician, considering factors like timing, medical history, and individual risk factors.

The availability of these two immunization pathways gives families flexibility in how they approach RSV protection. Whether through maternal vaccination or infant antibody treatment, the goal remains the same: keeping babies healthy and out of the hospital during their most vulnerable months.