RSV protection for newborns: what parents need to know
Respiratory syncytial virus (RSV) causes a cold in most adults, but in young babies it can cause bronchiolitis - an infection of the small airways in the lungs that makes breathing hard and feeding difficult. It is one of the most common reasons babies are admitted to hospital, usually in their first autumn or winter. Over the last few years many countries have added a way to protect newborns against it.
Two ways to protect a baby
Countries use one of two approaches, and some offer both:
- A vaccine in pregnancy. The mother has a single RSV vaccine late in pregnancy. Her body makes antibodies, which pass across the placenta, so the baby is born already protected for the first months of life.
- An antibody injection for the baby. A single injection of a long-acting antibody (nirsevimab, brand name Beyfortus) gives the baby ready-made protection for about five to six months - long enough to cover one RSV season. It is not a vaccine in the traditional sense: it does not ask the baby's immune system to do anything.
Where both are available, families normally have one or the other, not both. If the mother had the vaccine in pregnancy, the baby usually does not need the antibody too - unless the baby was born very soon after the vaccine was given, or has a condition that puts them at higher risk.
What different countries do
- UK: a vaccine in pregnancy, offered from 28 weeks.
- Germany: the antibody injection is recommended for all babies before their first RSV season - in autumn for babies born from April to September, and as soon as possible after birth for babies born during the season.
- France: a national autumn campaign. Parents choose either the antibody for the baby (often given in the maternity unit) or the vaccine in pregnancy at 32 to 36 weeks.
- Australia: a free vaccine in pregnancy at 28 to 36 weeks, plus state and territory programmes that offer the antibody to babies whose mothers did not have it and to higher-risk babies.
- Canada: the national advisory committee recommends the antibody for all babies in their first RSV season; each province and territory runs its own programme.
- United States and Ireland: see the country pages - both protect babies through the RSV season using these products.
Programmes are new and still changing, so check our RSV guide and your own country's page for the current details, and ask your midwife or health visitor what is offered where you live.
Is it safe?
Both products went through clinical trials before being licensed and have since been given to hundreds of thousands of babies and pregnant women. Side effects are usually mild: a sore arm, tiredness or headache for the mother after the pregnancy vaccine; occasionally a little redness or swelling, a mild rash or fever for the baby after the antibody. The antibody can be given at the same visit as other baby vaccines.
Signs of RSV to watch for
Even with protection, babies can still catch RSV - it is usually milder. Get medical advice urgently if your baby is breathing fast or working hard to breathe (you may see the ribs sucking in), has pauses in their breathing, is feeding less than half their usual amount, has fewer wet nappies, or seems floppy or unusually sleepy. Call emergency services if your baby's lips or tongue look blue or grey, or they stop breathing.
Practical habits still help in the RSV season: washing hands before holding the baby, keeping them away from people with colds where you can, and not smoking around them.
Sources
- NHS - RSV vaccine
- Robert Koch Institute - RSV prophylaxis recommendation (Germany)
- HAS - Beyfortus (nirsevimab) (France)
- Australian Government - RSV products program advice
- Public Health Agency of Canada - NACI statement on RSV in infants (summary)