Ask AI
Back Back
Infant RSV Prevention Q and A
Q&A on Infant RSV Prevention: Putting Experts in the Hot Seat

Released: May 18, 2026

Pablo J. Sanchez
Pablo J. Sanchez, MD
Michael J. Smith
Michael J. Smith, MD, MSCE
Brenda L. Tesini
Brenda L. Tesini, MD
Activity Information

Activity

Progress
1
Course Completed
Continue
Key Takeaways
  • In the absence of maternal vaccination, if an infant is born within 14 days of maternal vaccination, or if the date of maternal vaccination is uncertain, infants younger than 8 months who are born in or are entering their first RSV season should be given RSV immunization.
  • If there is uncertainty regarding whether an infant should be immunized at the tail end of an RSV season, refer to local epidemiology and individual risk factors.

In this commentary, a panel of healthcare professionals (HCPs) answers audience questions from a symposium on respiratory syncytial virus (RSV) prevention in infants. 

If an infant patient is on extracorporeal membrane oxygenation (ECMO) following surgery or during serious illness, when should additional RSV immunization be given? 

Pablo J. Sanchez, MD:
I wouldn't give it immediately. It depends on the practice setting, but if it is still within the RSV season, I would wait until NICU discharge to give any additional RSV antibody.

What do you do if the date of maternal vaccination is not 100% clear? 

Pablo J. Sanchez, MD:
I would give infant immunization in the form of RSV antibodies just in case the date of maternal vaccination was less than 14 days. 

How would you counsel a parent who wants to immunize their baby, even if the mother has been vaccinated more than 14 days prior to delivery?

Michael Smith, MD:
I have come across this in real life. It was a colleague of mine who asked for one of their patients. I tried to reassure them that it’s not really needed by showing them the vaccine clinical trial data, demonstrating that the maternal vaccine is very efficacious at preventing RSV in infants.

Pablo J. Sanchez, MD:
I would assure the parents that by virtue of the mother having received the vaccine, the baby has been protected. I would also tell them that they can further protect by breastfeeding and preventing potential exposure to RSV, especially in the first couple of months of age. That is, don't let people who are sick be with your child.

In my practice, the RSV antibody is administered until April 30th. However, should we recommend waiting until September to immunize infants, for better coverage during the majority of the RSV season?

Brenda Tesini, MD:
I think all infectious disease is local. That is, the right recommendation depends on knowing your local epidemiology, whether RSV is still circulating at that time of year. Especially for very young infants, who are the most vulnerable, the recommendation depends on whether RSV is still circulating in your community. If it is still circulating, then it should be given to protect the infant the remainder of that first season.

If the RSV season is too long, or in places where there is no RSV seasonality, would you consider recommending a second dose of infant RSV antibodies at 6 months?

Pablo J. Sanchez, MD:
I would not, as the recommendation is currently for 1 dose only. However, my colleagues and I struggle with babies born at the tail end of the RSV season, such as in April. It is a matter of balancing early immunization, when babies are most at risk due to age, vs protection through more of the RSV season. If the infant is high risk, I would recommend the 1 dose of RSV antibodies earlier because the younger the baby, the more likely they're going to have worse disease.

Michael Smith, MD:
I agree, and would like to add that if the infant or child is at increased risk for severe RSV, they would still be eligible for immunization entering their second RSV season.

What needs to change to bridge the gaps to RSV immunization for every infant? Is it public policy, education of HCPs or the general public, or all of the above?

Brenda Tesini, MD:
I would say that education of HCPs is key to improving uptake of RSV immunization. One of the most important predictors of immunization is a strong recommendation from a trusted HCP. I think giving HCPs the tools to make that strong recommendation would make a big difference. Obviously, we also need the infrastructure to have the product readily available to those who are willing to accept maternal vaccination and infant immunization.

What can community pharmacists do to support infant RSV immunization?

Michael Smith, MD:
This is a great question. I'm not aware of any community pharmacies with the infrastructure to administer infant RSV antibodies, so I think the way that community pharmacists can help the most is by being vaccine advocates. Community pharmacists will likely see new or expectant mothers, as well as grandparents and other family members. Interacting with these people is a great opportunity to advocate for them to get vaccinated if they're at high risk and to educate them on the potential seriousness of RSV infection.

Pablo J. Sanchez, MD:
I think that community pharmacists can certainly play a big role in increasing uptake of the maternal RSV vaccine, since so many people are getting their immunizations there. It could be as simple as putting up signs about it, like we would in the OB-GYN offices, postpartum areas, and newborn nurseries.

Your Thoughts
What do you think is the right call for immunizing infants born at the tail end of an RSV season? Do you have any questions about RSV immunization that weren’t answered here? Leave a comment to join the discussion!

Continue