There are two main ways to prevent serious RSV illness in babies: immunization (either during pregnancy or shortly after birth) and everyday hygiene measures that reduce your baby’s exposure to the virus. RSV sends tens of thousands of infants to the hospital each year in the United States, but the protection options available today are more effective than anything parents had even a few years ago.
Two Immunization Options for Every Baby
The CDC recommends that all babies be protected from severe RSV through one of two immunization routes: a maternal vaccine given during pregnancy, or an antibody shot given directly to the baby after birth. Most babies do not need both.
Which path makes sense depends on timing. If you’re between 32 and 36 weeks pregnant during September through January, you’re eligible for the maternal RSV vaccine (Abrysvo). The vaccine prompts your body to produce protective antibodies that cross the placenta and shield your baby during their most vulnerable first months. In the phase 3 clinical trial, it reduced the risk of RSV hospitalization by 68% in the first three months of life and 57% through the first six months. The protection against the most severe outcomes, like dangerously low oxygen levels or ICU admission, was even stronger: 82% in the first three months and 69% through six months.
If you didn’t receive the vaccine during pregnancy, your vaccination status is unknown, or your baby was born within 14 days of vaccination (not enough time for antibodies to transfer), your baby should receive a long-acting RSV antibody called nirsevimab instead. This is a single injection, not a vaccine. It gives your baby ready-made antibodies rather than asking their immune system to produce its own.
One important detail: if you received the maternal vaccine during a previous pregnancy, the CDC does not currently recommend getting it again in a later pregnancy. Instead, that next baby should receive the antibody shot after birth.
When Your Baby Should Get the RSV Antibody
Timing matters because RSV circulates seasonally, peaking from fall through spring in most of the country. The CDC recommends administering the antibody between October and March. Babies born during that window should ideally receive it within their first week of life, during the birth hospitalization. Babies born between April and September should get the shot shortly before RSV season begins, typically in October or November.
For higher-risk children between 8 and 19 months old entering their second RSV season, the antibody is also recommended. Your pediatrician can determine if your child qualifies based on their medical history.
Extra Protection for High-Risk Babies
Some infants face a significantly higher risk of severe RSV and may need additional protection beyond the standard options. An older monthly antibody treatment called palivizumab is still used for specific high-risk groups during RSV season:
- Very premature infants: Babies born before 29 weeks who are younger than 12 months at the start of RSV season.
- Chronic lung disease of prematurity: Infants born before 32 weeks who needed supplemental oxygen for at least 28 days after birth.
- Significant congenital heart disease: Babies under 12 months with heart conditions that affect blood flow, particularly those on medication for heart failure or those with moderate to severe pulmonary hypertension.
- Impaired airway clearance: Infants with neuromuscular conditions or anatomical abnormalities that make it hard to cough and clear secretions.
- Severely weakened immune systems: Children under 2 who are profoundly immunocompromised.
If your baby falls into any of these categories, your pediatrician will likely bring up a protection plan before RSV season starts.
How RSV Reaches Your Baby
Understanding how the virus spreads helps you build practical defenses around your newborn. RSV travels through respiratory droplets when an infected person coughs or sneezes, through direct contact like kissing a baby’s face, and through contaminated surfaces. Older siblings are a common entry point: they pick up RSV at school or daycare, often experiencing mild cold symptoms themselves, and bring it home to a more vulnerable infant.
The virus is surprisingly resilient outside the body. On hard, nonporous surfaces like countertops and doorknobs, RSV can survive 3 to 30 hours at room temperature. Countertops can harbor infectious virus for up to 7 hours, rubber or plastic surfaces for about 5 hours, and fabric for around 2 hours. On skin, it lasts roughly 20 minutes. That’s enough time for a toddler to sneeze on a toy, set it down, and have a caregiver pick it up and touch their own face or the baby’s.
Everyday Habits That Lower Risk
Frequent handwashing is the single most effective everyday measure against RSV. Wash your hands before picking up your baby, after being in public spaces, and after contact with anyone who has cold symptoms. Ask anyone who holds your baby to do the same. Soap and water works well; hand sanitizer is a reasonable backup when a sink isn’t available.
During peak RSV season (roughly October through March), keep your newborn away from large crowds and anyone who is visibly sick. This includes well-meaning relatives with “just a cold.” In adults and older children, RSV often looks like a mild upper respiratory infection, so it’s easy to dismiss. If visitors have any symptoms, including a runny nose, coughing, or sneezing, ask them to wait until they’ve fully recovered before meeting the baby.
Regularly clean surfaces your baby or older children touch, especially shared toys, highchair trays, and doorknobs. Given how long RSV survives on hard surfaces, a quick wipe-down with standard household disinfectant makes a real difference during the winter months.
Keep Tobacco Smoke Away
Exposure to secondhand cigarette smoke after birth is linked to more severe RSV illness. Research published in Pediatrics found that infants exposed to postnatal cigarette smoke from their mother had lower oxygen levels during RSV bronchiolitis compared to unexposed infants. In multivariate analysis, smoking was one of the independent factors associated with how severe an RSV infection became. Keeping your home and car completely smoke-free, and asking caregivers who smoke to change clothes and wash hands before holding the baby, reduces this compounding risk.
Breastfeeding and General Health
Breast milk contains antibodies and immune factors that offer some baseline protection against respiratory infections, including RSV. While breastfeeding alone won’t prevent RSV, it supports your baby’s immune defenses during the months they’re most vulnerable. Combined with immunization and good hygiene habits, it’s one more layer in a practical prevention strategy.
Keeping your baby’s environment well-ventilated, avoiding overcrowded indoor spaces during peak season, and staying current on all routine pediatric visits also help ensure that if your baby does encounter RSV, their overall health gives them the best chance of a mild course.