RSV: Myth vs. Fact

Any time respiratory season rolls around, the questions start flooding in:

• Does RSV go away on its own?
• Can antibiotics cure RSV?
• Should you get the RSV vaccine if you’re pregnant?

With so many questions, there have been some competing answers, leading to myths you shouldn’t trust about respiratory syncytial virus (RSV).

Pediatrician Kristin Barrett, MD, sheds light on some of the most common myths around RSV and why this respiratory illness is something to take seriously.

What are the misconceptions around RSV?

Why are there still so many questions about RSV? Well, Dr. Barrett says it might have a lot to do with our fears, particularly for parents of young children.

“Fear can breed misinformation,” notes Dr. Barrett. “We start grasping at straws because we’ll do anything to protect our babies. But there are real answers and real guidance out there from trusted sources.”

Dr. Barrett addresses common RSV myths and misconceptions.

Myth 1: RSV is rare

RSV is common. So common, in fact, that by the age of 2, most kids will either be exposed to or infected by RSV.

“RSV spreads by respiratory droplets from coughing or sneezing,” explains Dr. Barrett. “It can also live on surfaces for several hours, so it’s highly contagious.”

Myth 2: RSV only affects infants and young children

Anybody can become infected with RSV, including adults. But children and young infants are at higher risk of getting sick with the virus because of their small anatomy.

“RSV likes to go to the tiniest parts of the lungs called the bronchioles,” explains Dr. Barrett. “Adults can tolerate a little bit of mucus, swelling or inflammation in those areas. But in babies, even the smallest amount of inflammation or mucus can block the bronchioles and cause problems with breathing.”

Myth 3: RSV is always a mild cold

For some, RSV can look similar to the common cold with mild symptoms, like fever, cough and a runny nose. But serious complications can also occur, such as:

• Lack of oxygen
• Shallow or fast breathing
• Retractions, or the sinking of skin around the neck and chest
• Dehydration

Myth 4: Healthy babies don’t need RSV vaccines

“RSV is the most common reason healthy children under the age of 1 get admitted to the hospital,” reports Dr. Barrett. “That’s why we recommend that all infants 8 months or younger get RSV antibodies during their first RSV season.”

Injections of monoclonal antibodies in the form of nirsevimab (Beyfortus®) and clesrovimab (Enflonsia®) are so effective that they lower the risk of a child needing medical attention during an RSV infection by 70% to 80%.

“As soon as they get those RSV antibodies, they start working to protect them from future infections,” says Dr. Barrett.

Myth 5: RSV immunization can give your child RSV

RSV antibodies don’t contain any of the actual virus that causes the illness. So, infants won’t get RSV from these injections.

There’s a different kind of RSV immunization available during pregnancy. It’s called Abrysvo® (RSVpreF). This vaccine is given between weeks 32 and 36 of pregnancy and at least 14 days before your due date.

“You won’t get RSV from Abrysvo because it doesn’t contain a live virus, but your body will still recognize it and make antibodies against RSV,” explains Dr. Barrett. “Those antibodies cross the placenta during pregnancy, helping to protect your baby against RSV after birth.”

Myth 6: RSV infant vaccines aren’t necessary if you got it during pregnancy

This one is actually true in some cases, unless your baby is born early or at high risk for severe complications from RSV.

“The antibodies will continue to circulate in the baby’s immune system for about six months after birth,” says Dr. Barrett. “The baby would probably not need to get the RSV monoclonal antibodies unless they’re at high risk for complications.”

Your baby’s risk for complications increases if they’re born preterm or if they have other conditions, like congenital heart disease or genetic disorders.

“If you got the vaccine appropriately at 35 weeks, but you went into labor and had the baby six days later, that baby should still get the RSV vaccine because you didn’t have enough time to make antibodies and pass them on to the baby,” she clarifies.

Myth 7: RSV only happens during winter

RSV is a common winter illness that tends to peak during respiratory season. In the U.S., that tends to fall between October and March. But you can get RSV all year long.

“RSV is a virus, so it can change or be affected by things like seasonal weather patterns,” says Dr. Barrett. “I’ve seen babies have RSV in the middle of June. It’s unusual, but it can happen.

Myth 8: There aren’t any long-term effects from RSV

Remember, RSV affects the tiniest part of your lungs. When you’re young, those parts are still developing. So, if they’re under severe stress from RSV, it can have a lasting impact on how they function.

“Because of how RSV behaves in the body, it’s a very common cause of wheezing,” says Dr. Barrett. “Children who wheeze with RSV early in life, especially during their first year, are much more likely to go on to develop asthma or reactive airway disease.”

Older adults who have RSV can also experience other long-term effects that increase their risk of:

• Pneumonia
• Asthma
• COPD
• Heart disease

Myth 9: You can only catch RSV once in your life

Like the flu and other viruses, you can get RSV more than once. Part of the reason is that the virus can change and slip past your immune system’s defenses. With each recurring infection, symptoms can change, too.

“For most older kids and young adults, RSV becomes more like a common cold with congestion or a mild cough,” says Dr. Barrett. “It usually doesn’t cause severe illness in those groups.”

Myth 10: RSV goes away on its own, so you don’t need to see a doctor

Viruses typically go away on their own. Treatment usually revolves around reducing the severity of symptoms. But severe symptoms should be taken seriously.

“We tend to see RSV symptoms peak on about day three to five,” says Dr. Barrett. “We start to see significant improvement around day seven, with babies feeling back to normal after about one to two weeks.”

Dr. Barrett says to take your baby to the hospital if they:

• Turn blue
• Flare their nostrils when breathing
• Suck in their ribs, neck or shoulders when breathing
• Have fast or shallow breaths
• Pause between breaths
• Have dry mouth or dry diapers
• Have difficulty waking up or seem lethargic

To help prevent hospitalization, you can use Tylenol® to treat aches and bring down a fever. Drinking plenty of fluids can help keep someone with RSV hydrated. And to help young babies and children with RSV breathe better, Dr. Barrett recommends:

• Using suction devices to clear out the mucus building in their airways
• Turning on a humidifier to improve congestion and cough
• Running a warm, steamy shower and sitting in a bathroom to help them breathe in moisture

Myth 11: Antibiotics can cure RSV

Antibiotics are short-term medications that kill bacteria and stop them from multiplying. They’re helpful when treating bacterial infections like strep throat or pink eye. But as a virus causes RSV, not a bacterium, antibiotics aren’t helpful when treating RSV.

But they may be needed in some cases.

“Some babies can get what we call bacterial superinfections, meaning they get a bacterial infection on top of having RSV,” says Dr. Barrett. “The most common one we see is an ear infection, and we use antibiotics to treat those while RSV runs its course.”

Myth 12: There are no ways to prevent RSV

Looking for the best prevention against RSV? Dr. Barrett recommends the following:

• Get the appropriate RSV vaccines or injections.
• Avoid sharing straws, utensils or drinks with someone who’s sick.
• Keep up with hand-washing and general hygiene recommendations.
• Clean hard surfaces, like shopping carts, before babies encounter them.
• Avoid people who are sick.
• Try not to kiss or touch your baby’s face.

“We know taking these precautions are helpful because they help keep other viruses at bay,” encourages Dr. Barrett. “If taking these precautions helps prevent serious symptoms, that’s an important consideration to keep in mind.”