By Shane Reeves, PharmD, CEO, TwelveStone Health Partners
The respiratory syncytial virus (RSV) season starts in the fall and peaks in the winter, so October is a good time to talk with your healthcare provider about prevention. RSV causes a mild, cold-like illness for many people, but it leads to serious complications in infants, older adults, and people with certain health conditions.
Prevention options have expanded in recent years. Vaccines help protect eligible adults and pregnant people, while long-acting monoclonal antibodies help protect eligible infants and certain young children. These options reduce the risk of severe illness before RSV exposure or early in the season. CDC guidance draws an important distinction: prevention options reduce the risk of severe RSV, but they don’t treat an active RSV infection.
Who’s at Higher Risk for Severe RSV?
RSV causes congestion, cough, fever, wheezing, and changes in appetite. Many otherwise healthy adults recover at home in one to two weeks. However, RSV poses a greater risk to:
- Infants and young children, especially very young infants
- Adults 75 and older
- Adults 50 to 74 with certain health conditions or other factors that increase their risk
- People with chronic heart or lung disease, weakened immune systems, frailty, or other conditions that make respiratory illness more serious
- Adults who live in nursing homes or long-term care settings
RSV causes pneumonia in adults and worsens asthma, COPD, and heart failure. Each year, RSV leads to an estimated 110,000 to 180,000 hospitalizations among U.S. adults ages 50 and older.
Vaccines and Monoclonal Antibodies
CDC recommends one RSV vaccine dose for all adults ages 75 and older and adults ages 50 to 74 who face an increased risk of severe RSV. If you have already received an RSV vaccine, CDC does not recommend another dose at this time. Your healthcare provider can help you decide whether vaccination is right for you.
Most infants need one of two approaches to help prevent severe RSV during their first season:
- Maternal RSV vaccination during pregnancy. Pfizer’s Abrysvo is given during weeks 32 through 36 of pregnancy, generally from September through January in much of the continental United States. The vaccine prompts the body to produce antibodies, which cross the placenta and help protect the baby after birth.
- A long-acting preventive antibody for the baby. Nirsevimab or clesrovimab gives eligible infants ready-made antibodies that help protect against severe RSV. These products are monoclonal antibodies, not vaccines, and they prevent severe illness rather than treat an active RSV infection.
CDC recommends nirsevimab for certain children ages 8 to 19 months who face an increased risk of severe RSV and enter their second RSV season. CDC’s infant and young-child guidance explains eligibility and timing.
Treating RSV: What Supportive Care Means
No routine antiviral medicine cures RSV. Instead, clinicians treat RSV with supportive care. For mild illness, rest, drink fluids, manage fever or pain as a healthcare professional recommends, and monitor symptoms closely. Never give aspirin to children.
Severe RSV sometimes requires hospital care. Clinicians give oxygen, IV fluids for dehydration, or respiratory support when RSV causes serious breathing problems. Contact a healthcare provider promptly if breathing worsens, fluid intake drops, dehydration develops, or symptoms worsen in an infant, older adult, or person with chronic conditions.
Seek emergency care or call 911 if someone has severe trouble breathing, blue or gray lips or face, becomes unresponsive, or shows other signs of a life-threatening emergency. CDC respiratory-virus guidance offers additional information about when to seek urgent evaluation.
Plan for RSV Season
RSV prevention works best before the season peaks. Talk with your healthcare provider this month about the options that apply to you or your family, including RSV vaccination for eligible adults, vaccination during pregnancy, or a preventive antibody for an eligible infant.
Your provider can help you understand which option fits your age, health needs, pregnancy status, or a child’s eligibility and when to seek care if RSV symptoms become more serious.
