RSV Vaccine for High-Risk Infants

Respiratory syncytial virus, or RSV, can cause serious complications, despite what some people may believe.

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“Almost every child is exposed to RSV by age 2, but high-risk kids are more likely to catch RSV and become severely ill with serious complications,” says pediatrician Kristin Barrett, MD.

Dr. Barrett explains what treatment options and preventive measures are most helpful and what you can do to protect your baby from serious RSV complications.

What are the RSV vaccine recommendations for high-risk infants?

There are two ways to protect your baby from RSV: during pregnancy and after birth:

During pregnancy: You can get an injection of Abrysvo® (RSVpreF) at least 14 days before your due date, usually during 32 to 36 weeks of pregnancy. “This injection provides a baby with enough antibodies during its first six months of life to fight RSV,” says Dr. Barrett.
After birth: Your baby can get a dose of nirsevimab (Beyfortus®) or clesrovimab (Enflonsia®) during their first or second RSV season. During the first 18 months of life, these synthetic proteins help boost a child’s ability to fight off an RSV infection and reduce the severity of their symptoms.

“Abrysvo provides a baby with enough antibodies during its first six months of life to fight RSV,” reiterates Dr. Barrett. “If you get that injection during pregnancy, the American Academy of Pediatrics says your baby should receive monoclonal antibodies during their second respiratory season.”

Your baby may benefit most from these vaccines if they:

Are born preterm before 32 weeks
Are immunocompromised
Are of American Indian or Alaska native descent
Have chronic lung disease
Have congenital heart disease
Have neuromuscular disorders, like Duchenne muscular dystrophy
Have genetic disorders, like Down syndrome or Klinefelter syndrome

What can you do to protect your baby from RSV?

The best preventive measures against RSV, especially for high-risk infants, continue to be the pre-birth RSV injection and post-birth monoclonal antibodies. Other precautionary measures include:

Washing your hands with soap regularly
Applying general hygiene recommendations
Limiting your baby’s exposure to the environment and other sick people

“RSV is spread through respiratory droplets, so anyone who has it should wear a mask and distance themselves from you and your baby while they’re ill,” says Dr. Barrett. “It also helps to avoid large social settings during the first year of life if you have a high-risk infant.”

What do you do if your high-risk infant gets RSV?

Even if you take every precaution available to you, it’s still possible your baby could get RSV. It is, after all, a common winter illness that almost everyone faces at least once in their life.

If you’re concerned about your baby’s health or notice any of the following symptoms, reach out to a healthcare provider for treatment:

Blue lips, fingers or skin
Flared nostrils when breathing
Retractions of their ribs, neck or shoulders when breathing
Fast or shallow breaths
Wheezing or gasping
Pauses in breath
Dry diapers or dry mouth
Difficulty waking up or changes in energy

“RSV is a virus, so it could take up to a week or more for it to go away on its own,” explains Dr. Barrett. “Do what you can to make your baby comfortable and monitor them closely. If they’re having trouble breathing or you’re noticing any concerning symptoms, take them to a hospital right away.”

There, a care team can administer fluids, oxygen and other medications to help your baby fight off the RSV infection.

“We can provide round-the-clock monitoring and have access to things you can’t do at home, like medical-grade suctioning, to help clear out mucus from your baby’s nose and throat,” reassures Dr. Barrett. “For the most part, once a baby is released from the hospital, they’re able to make a full recovery.”