Jun 18, 2023

How to Prevent RSV in Adults and Children

Respiratory syncytial virus (RSV) is a common, highly contagious illness that affects the nose, throat, and lungs. Although RSV usually causes mild illness with cold-like symptoms, the infection can cause severe respiratory illness in infants, young children, older adults, and people with weakened immune systems or underlying health conditions.

In the United States, RSV season begins in the fall and peaks in the winter. While there is no cure for RSV, there are ways to lower your risk of infection. This article explores practical steps to prevent RSV, including at-home measures, vaccinations, and medications to safeguard yourself and your loved ones against RSV.

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Every year, an estimated 64 million people worldwide experience RSV infections. RSV spreads through contact with respiratory droplets of an infected person when they cough, sneeze, or talk, or by touching objects that have the virus on them (e.g., doorknobs, toys) and then touching your eyes, nose, or mouth.

You can help limit the spread of RSV and lower your risk of infection by practicing simple and effective habits daily, such as:

Most children have had and recovered from at least one RSV infection by age two. RSV usually causes mild symptoms, but some infants and young children are at risk of severe illness that may require hospitalization. Taking simple protective measures can help lower your child’s risk of RSV.

People of all ages can become infected with RSV. While the virus usually causes mild symptoms that resolve within a week or two, some groups are at higher risk of developing severe RSV infections, including:

Infants have underdeveloped immune systems and smaller airways more prone to swelling and congestion. This makes babies more susceptible to severe RSV complications, such as bronchiolitis (inflammation of the airways) and pneumonia (lung infection).

For older adults, age-related lung and respiratory function changes coupled with a slower immune response increase the risk of severe respiratory infections. RSV infections may worsen symptoms of underlying health conditions in older adults, such as asthma, heart failure, or chronic obstructive pulmonary disease (COPD).

Research breakthroughs have led to the development of RSV vaccines specifically targeted to protect high-risk groups from the impact of RSV. In May 2023, the Food and Drug Administration (FDA) approved two RSV vaccines for older adults (ages 60 and up): GSK’s Arexvy and Pfizer’s Abrysvo.

The vaccines, given in a single dose, stimulate the immune system to produce antibodies to protect against severe RSV infections and complications (e.g., pneumonia). In clinical trials, both vaccines were shown to be highly effective:

The Centers for Disease Control and Prevention (CDC) strongly recommends that people ages 60 and older discuss RSV vaccination with a healthcare provider.

In August 2023, the FDA approved an RSV vaccination for pregnant people between weeks 32 and 36 gestation, to prevent occurrence of the illness in infants. Research suggests the vaccine may pass maternal RSV antibodies onto the fetus to protect newborns from the virus for the first six months of life. Clinical trial results showed Abrysvo was 81.8% effective in preventing severe RSV in infants for the first six months of life.

The FDA approved a promising new preventive option for protecting babies against severe RSV in July 2023. Beyfortus (nirsevimab) is a monoclonal antibody antiviral drug administered as a single intramuscular injection for infants and young children up to 24 months old. It provides antibodies that help bolster an infant’s immune system to prevent severe lung disease (e.g., pneumonia) caused by RSV.

Research shows Beyfortus may reduce the risk of RSV-related hospitalizations and healthcare visits in infants by up to 80%. The CDC recommends one dose for infants eight months and younger born in or during their first RSV season and one dose for those between 8 and 19 months with an increased risk of severe RSV infection. While generally safe, the drug may cause mild side effects such as rash or irritation at the injection site.

While Beyfortus is a powerful tool in preventing RSV in infants, parents and caregivers should continue implementing other preventative measures, including frequent handwashing, avoiding close contact with sick people, and maintaining a clean environment.

For high-risk babies and young children under 24 months of age vulnerable to severe RSV infections, specialized preventive medications offer an extra layer of defense. Synagis (palivizumab) is an antiviral monoclonal antibody designed to protect against severe RSV illness in infants and young children at high risk of complications, including those born prematurely or with heart or lung diseases.

Palivizumab is administered as a monthly injection during RSV season. It helps boost the immune system to stop or slow the spread of RSV in the body, but it cannot prevent infection and is not used to treat symptoms once a child has RSV. While generally well-tolerated, palivizumab may cause side effects such as fever, rash, pain, and swelling at the injection site.

People with RSV are usually contagious for three to eight days and may be contagious for a day or two before symptoms develop. Infants and those with weakened immune systems may be contagious for up to four weeks, long after symptoms resolve.

After exposure to RSV, there is an incubation period of approximately four to six days before symptoms develop. During this time, the virus replicates in the body, though you may have no signs of illness. When symptoms develop, they usually last between one and two weeks, with peak symptoms occurring in the first few days.

While symptoms like sneezing, runny nose, and decreased appetite may improve after the first week, coughing and congestion can persist for weeks. To prevent the spread of RSV when you’re sick, you can:

Respiratory syncytial virus (RSV) is a highly contagious respiratory illness that usually causes mild, cold-like symptoms. Infants, older adults, and people with weakened immune systems are vulnerable to more severe RSV infections that may require hospitalization. You can use at-home measures to prevent RSV. Recent research advancements have introduced RSV vaccines and monoclonal antibodies that protect specific populations from serious illnesses.

Talk to a healthcare provider to determine if RSV vaccination is right for you or if your baby or young child should receive monoclonal antibodies to help prevent RSV.

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Wash your hands regularly Avoid touching your eyes, nose, and mouthCover coughs and sneezesAvoid close contactDisinfect frequently touched surfaces, See a healthcare providerDiscuss RSV vaccinationWash your hands thoroughly Minimize your child’s exposureRegularly clean and disinfect surfacesEducate your child’s caregiversAvoid exposure to secondhand smokeBreastfeeding your baby