Preventing RSV relies on a combination of vaccines, antibody treatments for infants, and basic hygiene habits that limit how the virus spreads. Unlike many respiratory viruses, RSV does not produce lasting immunity. In one study, about half of adults became reinfected within two months and two-thirds within eight months of a previous infection. That means prevention is an ongoing effort, not something your immune system handles permanently after one bout.
How RSV Spreads
RSV travels through respiratory droplets when an infected person coughs or sneezes near you, through direct contact like kissing a child’s face, and through contaminated surfaces. That last route matters more than people expect: RSV can survive on hard, nonporous surfaces like doorknobs, countertops, and plastic toys for 3 to 30 hours at room temperature. Countertops specifically can harbor recoverable virus for up to seven hours.
This means touching a shopping cart handle or a shared toy and then rubbing your eyes or nose is a realistic way to pick up the virus. Young children, who constantly touch surfaces and then touch their faces, are especially vulnerable to this route.
Everyday Habits That Reduce Risk
Hand hygiene is the single most accessible prevention tool. Alcohol-based hand sanitizers are effective against RSV. Research shows that even 30% ethanol completely eliminates infectious RSV, and the WHO-recommended hand-rub formulations do the same. Standard hand sanitizers with 60% or higher alcohol content will work.
For surface cleaning, disinfectants based on alcohol, aldehyde, or hydrogen peroxide all neutralize RSV efficiently. Regular cleaning of high-touch surfaces during RSV season (typically fall through spring in most of the U.S.) makes a real difference, especially in homes with infants or older adults. Beyond cleaning:
- Avoid close contact with people who have cold-like symptoms, particularly during RSV season.
- Wash hands frequently with soap and water or use alcohol-based sanitizer, especially after being in public spaces.
- Keep hands away from your face, since the virus enters through the eyes, nose, or mouth.
- Stay home when sick to avoid spreading RSV to vulnerable people around you.
Vaccines for Adults 50 and Older
Three RSV vaccines are licensed for adults ages 50 and older: Arexvy (GSK), mResvia (Moderna), and Abrysvo (Pfizer). There is no preferred option among the three. The CDC recommends a single dose for all adults 75 and older, and for adults 50 to 74 who face increased risk of severe RSV illness. Increased risk includes conditions like chronic lung disease, heart disease, weakened immune systems, and living in nursing homes or long-term care facilities.
This is not an annual vaccine. One dose is currently considered a complete vaccination, with no booster recommended. You can get the vaccine at any time of year, but it offers the most benefit when given in late summer or early fall, before RSV season picks up. In most of the continental U.S., that means August through October is the ideal window.
Protecting Newborns Through Maternal Vaccination
Pregnant women can pass RSV-fighting antibodies to their baby before birth by receiving a single dose of Pfizer’s Abrysvo between 32 and 36 weeks of pregnancy. The vaccine needs to be given before 37 weeks so there is enough time for antibodies to develop and cross the placenta.
The protection this provides to newborns is substantial. In clinical trials, maternal vaccination reduced the risk of an infant being hospitalized for RSV by 68% in the first three months of life, and by 57% through six months. For the most severe outcomes, including dangerously low oxygen levels, the need for mechanical ventilation, or ICU admission, the reduction was 82% in the first three months and 69% through six months. This is especially valuable because newborns are too young to be vaccinated themselves and are the age group most likely to be hospitalized from RSV.
Antibody Protection for Infants
For babies who did not receive protection through maternal vaccination, an antibody product given by injection provides a different path. The CDC recommends administration during October through March in most of the U.S., with the ideal timing being October or November, just before RSV season starts. Babies born during RSV season (October through March) should ideally receive the injection during their birth hospitalization, within the first week of life.
Unlike a vaccine, which teaches the immune system to make its own antibodies, this product delivers ready-made antibodies directly. Protection was evaluated through 150 days (about five months) after injection in clinical studies. Babies born outside of RSV season (April through September) should receive their dose in October or November before the season begins.
Children at increased risk for severe RSV who are entering their second RSV season can also receive a dose, timed to October or November.
Extra Protection for High-Risk Infants
Some babies face a significantly higher risk of dangerous RSV illness and may qualify for monthly antibody injections throughout the RSV season. This older preventive treatment is reserved for specific groups:
- Premature infants born before 29 weeks of gestation, in their first RSV season
- Infants with chronic lung disease of prematurity, defined as birth before 32 weeks and needing supplemental oxygen for at least the first 28 days of life
- Infants with significant congenital heart disease who are on medication for heart failure or need cardiac surgery
- Infants with conditions that impair airway clearance, such as neuromuscular disease or cystic fibrosis with lung involvement
- Profoundly immunocompromised infants in their first or second RSV season
In the second RSV season, eligibility narrows. Children with chronic lung disease qualify only if they still need supplemental oxygen, corticosteroids, or diuretics in the six months before the season starts. Children with cystic fibrosis qualify if they were hospitalized for a lung flare-up in their first year or have persistent abnormalities on chest imaging.
Why Reinfection Happens
One of the frustrating realities of RSV is that your body never builds strong, lasting immunity to it. In a controlled study where adults were repeatedly exposed to the same RSV strain over 26 months, 73% were infected two or more times and 47% were infected three or more times. At every challenge point, at least one-quarter of participants became reinfected regardless of their antibody levels.
Antibodies to RSV do provide some short-term resistance, but that protection fades quickly and is never complete. This is why prevention strategies like vaccination, hygiene, and protecting vulnerable people during peak season remain important year after year, even for people who had RSV recently. For most healthy adults and older children, reinfection causes a bad cold. For infants, older adults, and people with chronic health conditions, each new infection carries the risk of serious illness.