As respiratory virus season begins, public health guidance for the respiratory syncytial virus (RSV) centers on targeted prevention for older adults, pregnant individuals, and infants, depending on age, health status, and immunization timing.
Targeted RSV Protection for Older Adults and High-Risk Populations
With the arrival of the respiratory virus season, public health discussion has turned back to the respiratory syncytial virus, commonly known as RSV. While many people experience only mild, cold-like symptoms, the virus can trigger severe illness and dangerous complications among infants, older adults, and individuals managing chronic medical conditions.
Guidance from the World Health Organization and the Centers for Disease Control and Prevention emphasizes that protection must be tailored rather than applied universally. According to current recommendations from the Centers for Disease Control and Prevention, the RSV vaccine is recommended for all adults aged 75 and older. The agency also advises vaccination for adults between 50 and 74 years old who face an elevated risk of severe infection due to underlying health factors.
Those qualifying health factors include chronic heart or lung disease, compromised immune systems, residency in nursing homes, or other specified medical conditions. Public health authorities note that the RSV shot is not currently administered as an annual vaccine; individuals who have received a prior dose do not automatically require a repeat shot each year.
Maternal Vaccination and Long-Acting Antibodies for Newborns
Protecting newborns requires a different approach since infants do not receive traditional RSV vaccines. Instead, prevention strategies focus on maternal immunization during pregnancy or administering long-acting monoclonal antibodies directly to the infant.
When a pregnant individual receives the vaccine during a specific window, antibodies pass through the placenta to shield the infant during the vulnerable early months of life. The World Health Organization recommends that the maternal vaccine, RSVpreF (ABRYSVO®), be given to pregnant women during the third trimester of pregnancy, from week 28 onwards, to optimize for the adequate transfer of antibodies to their baby.
The World Health Organization prequalified the multi-dose vial presentation of this maternal RSV vaccine, developed with support from the Gates Foundation, which is expected to make vaccination more affordable and easier to deliver in countries supported by Gavi, the Vaccine Alliance. This decision builds on the single-dose prequalification in March 2025 and Gavi’s decision in July 2025 to establish a maternal RSV vaccine program. For infants whose mothers were not vaccinated or whose birth timing falls outside the optimal window, long-acting monoclonal antibodies like nirsevimab can provide direct protection, with the World Health Organization recommending that countries introduce either the maternal vaccine or the monoclonal antibody into national programs.
Global Respiratory Impact Among Young Children
The emphasis on RSV prevention stems from its heavy toll on pediatric respiratory health worldwide. The virus ranks among the leading drivers of acute lower respiratory tract infections in young children, occasionally advancing to bronchiolitis, pneumonia, and severe breathing difficulties.
Data compiled by the World Health Organization shows that RSV accounts globally for more than 3.6 million hospital admissions and roughly 100,000 deaths annually among children under five years of age. Almost half of these deaths occur in infants younger than 6 months of age, and roughly 97% of RSV deaths occur in low- and middle-income countries where access to supportive medical care is limited and children often die at home before reaching a health facility, highlighting the widespread respiratory burden the virus places on vulnerable populations alongside older adults.
