August 22, 2023/Children's Health

Is There a Vaccine for RSV in Children?

Babies should get the RSV immunization before their first cold and flu season

Baby receiving vaccination from healthcare provider.

There are some things we know happen every fall.

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Leaves turn colors. The smell of pumpkin spice fills the air (and the candle aisle). Cozy sweaters emerge from the back of the closet.

And cold and flu season brings on sniffles.

But it’s more than runny noses and coughs that worry healthcare providers each autumn. It’s also the annual surge of respiratory syncytial virus (RSV) that fills up hospital beds and leaves parents in shambles as they worry about their babies.

RSV is a common upper respiratory virus that tends to peak in the fall alongside other infectious diseases, like colds, flu and COVID-19. It can affect anyone. And for most of us, RSV causes nothing more than some mild cold-like symptoms.

But in little babies — particularly those under 6 months old — RSV can be very dangerous. Even life-threatening.

Relief is on the way.

Shortly after the U.S. Food and Drug Administration (FDA) recently approved an RSV vaccine for older adults, it’s also approved an RSV immunization for babies. It’s called Beyfortus™ (generic name: nirsevimab). And, soon, a new vaccine will hit the market for people who are pregnant — protecting babies from RSV from their first day of life.

These new options are primed to be a game-changers for families and healthcare providers alike.

“No one wants to see little babies getting sick if we can prevent it,” says pediatric infectious disease specialist Frank Esper, MD. “These RSV immunizations give healthcare providers and parents some peace of mind knowing that we can protect our vulnerable infants from what can be a very dangerous infection.”

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How is the RSV immunization different from other vaccines babies need? And what do parents (and parents-to-be) need to know about RSV immunization? Dr. Esper walks us through it.

RSV immunization vs. vaccines

Strictly speaking, Beyfortus — the RSV prevention method for babies — isn’t a vaccine. It’s an immunization. And the difference is more than semantics.

When you get a vaccine, what you’re receiving is a teeny part of a deactivated virus. That virus spurs your immune system to create antibodies — proteins that hunt down and remove the virus from your body.

The RSV immunization, on the other hand, doesn’t use the RSV virus at all. Instead, it’s an injection of synthetically produced antibodies that are ready and raring to fight off RSV.

“By giving antibodies, we’re giving babies protection almost immediately after they get the shot,” Dr. Esper explains. “That protection lasts about six months — long enough to lower their risk of a serious infection during their first RSV season, which is when the virus is most dangerous for them.”

It’s like taking the middleman out of the equation. The RSV immunization makes it so antibodies are already circulating in your baby’s system if they’re exposed to the virus. Their body’s defenses are already in place — ready to fight off the virus. The result is a less serious infection, and a much lower risk of hospitalization.

Abrysvo, the RSV vaccine intended for use during pregnancy, is a true vaccine. That is, it delivers a bit of deactivated virus into the person who is pregnant. They create antibodies to fight off the infection, and they pass along those RSV antibodies to the developing fetus. The baby is born with some protection against severe RSV infection.

RSV immunization Q&A: Advice for parents

What do parents need to know about RSV immunization? We asked Dr. Esper a few questions so you can immunize with confidence.

Q: Why is RSV immunization important?

Babies who contract RSV can become very ill, sometimes needing to be hospitalized and hooked up to oxygen and IV fluids for dehydration. In fact, RSV is one of the most common reasons for babies to be admitted to the hospital.

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“RSV causes a lot of swelling in your airways,” Dr. Esper explains. “Babies’ windpipes are small to begin with, so it doesn’t take a lot of swelling to close them shut.”

Babies under 6 months old and babies born preterm or who have certain heart issues are most at risk for a severe RSV infection. But as children grow, their windpipes grow, too. So, when toddlers (or school-aged kids or teens or adults) get RSV, it can be uncomfortable, sure. But the symptoms are much more likely to be manageable using home remedies.

“Parents know just how much kids grow and change in their first year of life. The same is true for their immune systems. It’s evolving and working better every day,” Dr. Esper says. “It’s amazing to see what a one-year-old’s immune system can do for them, compared to what it was in the first days of their life.”

It’s important to note that RSV can also be dangerous in adults over the age of 60 and in people who are immunocompromised. That’s more because those groups of people are more likely to face certain complications following an RSV infection, particularly for older adults with conditions like asthma, heart disease or COPD.

Dr. Esper suggests that immunizing babies and pregnant people may bring some RSV protection to people around the baby as well. “What we’ve seen with other vaccines is that when we vaccinate our children, other people around them are less likely to get infected. Anyone with kids knows that when one person in the family gets sick, it tends to go through the whole house. So, by vaccinating a baby, that may mean less illness, too, for parents, siblings, grandparents and others who are around the baby.”

Q: Is the RSV immunization safe?

The Beyfortus immunization is backed by several research studies that confirm that it’s safe and effective.

The U.S. Centers for Disease Control and Prevention (CDC) states Beyfortus “has been shown to reduce the risk of both hospitalizations and healthcare visits for RSV in infants by about 80 percent.”

“The RSV immunization’s safety and efficacy has been supported by research on thousands of infants,” Dr. Esper shares. “We know this immunization is going to help keep babies safe from RSV.”

The only reported side effects from the immunization are possible soreness as the injection point and rash.

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In clinical trials of more than 3,500 pregnant people, Abrysvo reduced severe RSV infections in babies by more than 80% in their first three months and nearly 70% in their first six months. Some studies showed a possible association between the vaccine and preterm birth when the vaccine was given prior to the 32nd week of pregnancy. Additional studies are expected as the vaccine becomes available.

Q: Who should get the RSV immunization and when?

Beyfortus is meant for babies up to 8 months old as they enter their first RSV season. Essentially, that means babies should be immunized heading into their first autumn, or just after birth for babies born between October and February (in the Northern Hemisphere).

The idea is that the RSV immunization can help tiny infants get them through their first potential exposure to RSV with less serious symptoms.

The following year, when their windpipes have grown and their risk is lessened, most toddlers will be able to better fight off an RSV infection on their own. A second dose of Beyfortus may be recommended for toddlers entering their second RSV season if they have underlying lung heart or immune problems.

People who are pregnant may be eligible for the Abrysvo vaccine between the 32nd and 36th week of pregnancy. Babies whose birth parent was given the Abrysvo vaccine won’t also need the Berfortus immunization.

Q: What else can I do to protect my baby from RSV?

Immunization for RSV is just one part of a multipronged approach to keep your baby healthy.

“Immunization is one more shield we can use to keep babies healthy from viruses. But even with immunization, it’s important to keep practicing good infection-control strategies,” Dr. Esper advises.

That means things like:

  • Washing your hands regularly with soap and water. (And encouraging anyone who’s going to touch or hold your baby to scrub up, too.)
  • Covering your cough.
  • Not allowing people who are sick to be around your baby.
  • Keeping your baby home if they’re showing signs of being sick, like a runny nose or cough.

Q: How do I get an RSV immunization for my baby?

Beyfortus was recently approved by the FDA and is now being made available to the public. Abrysvo is expected to be available soon.

“We know that immunizing kids against infectious disease makes children healthier,” Dr. Esper says. “The RSV immunization is a huge win for the infants of the United States and around the world. We can stop RSV.”

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