Respiratory Syncytial Virus (RSV) is a common respiratory virus that infects the lungs and breathing passages. Nearly all children contract the virus by the time they are two years old, but for certain populations, the infection can become severe, leading to hospitalization. The greatest risks are concentrated among two groups: infants, especially those under six months of age, and older adults, particularly those aged 65 and over or those with underlying heart or lung conditions. Because RSV is highly contagious and can cause serious illness in the most vulnerable, protective measures are necessary to limit its spread and impact within a family and community.
Daily Habits for Reducing Transmission
Preventing the spread of RSV begins with behavioral changes. Frequent handwashing with soap and water for at least 20 seconds remains the most effective action, especially after coughing, sneezing, or being in public. Because RSV can survive on hard surfaces for several hours, regularly cleaning and disinfecting high-touch areas like doorknobs, remote controls, and shared toys is also important.
People should practice proper respiratory etiquette by covering coughs and sneezes with a tissue or the elbow to contain infectious droplets. If a person is experiencing cold-like symptoms, they should stay home from work or school. Limiting close contact, such as kissing or sharing utensils with vulnerable individuals like infants or the elderly, is particularly advised when feeling unwell.
Vaccination Options for Adults and Pregnant Individuals
Active immunization through vaccination provides a powerful layer of protection by prompting the body to produce its own antibodies against the virus. Several RSV vaccines are available for adults, generally recommended for those aged 60 and older. These vaccines are typically administered as a single dose and are not currently recommended annually, unlike the influenza vaccine. The ideal time to receive the shot is in late summer or early fall, just before the RSV season typically begins.
The maternal RSV vaccine is available for pregnant individuals to protect their newborns. Given during the third trimester, it causes the mother’s immune system to generate protective antibodies. These antibodies then cross the placenta, entering the fetal bloodstream to provide the newborn with immediate, temporary protection after birth. Current guidelines recommend receiving this single-dose maternal vaccine between 32 and 36 weeks of pregnancy, typically during the peak RSV season months of September through January.
This strategy is designed to protect the infant through their most vulnerable period, lasting for the first six months of life. Maternal active immunization is considered an alternative to the passive immunization offered directly to the infant, as most babies do not require both interventions for protection.
Specialized Protection for Infants and Vulnerable Children
For infants, a different approach called passive immunization is used, which involves directly administering pre-made antibodies. The long-acting monoclonal antibody product, nirsevimab, is a primary tool in this strategy, providing protection against severe RSV disease for an entire season with a single injection. Unlike a vaccine, which trains the body to create antibodies, this monoclonal antibody neutralizes the virus upon exposure.
This intervention is recommended for all infants under eight months old who are born during or are entering their first RSV season. It is ideally administered just before or at the start of the season, or for babies born during the season, it can be given before hospital discharge.
The monoclonal antibody is also recommended for certain high-risk children between 8 and 19 months of age who are entering their second RSV season. This includes children with conditions such as chronic lung disease from prematurity, a severely weakened immune system, or certain complex heart diseases. If a pregnant individual received the maternal RSV vaccine, the infant receives a high level of antibodies and generally does not need the monoclonal antibody product. The decision between maternal vaccination and infant antibody administration should be discussed with a healthcare provider based on the family’s specific circumstances and timing.