CDC recommends RSV vaccine, monoclonal antibodies in official immunization schedule update

New parents, take note: the Centers for Disease Control and Prevention is including vaccinations and treatments to protect against respiratory syncytial virus — better known as RSV — in its recommended vaccination schedule for infants.

The treatments — an RSV vaccine recommended during pregnancy to protect the baby before birth, and a monoclonal antibody injection to give babies protection against RSV directly — both became available in 2023. This year is the first time they’ve made it into the vaccination schedule list, which is updated annually.

The shots help to protect infants at a vulnerable time in their lives. The first six months after birth are when babies are most at risk for the worst respiratory symptoms of RSV, doctors say.

“It can go into their very tiny airways and cause them to have trouble breathing,” said pediatrician Joe Aracri, chair of Allegheny Health Network’s Pediatric Institute.

The monoclonal antibody treatment gives a baby the antibodies to protect against RSV directly instead of teaching the immune system with a dead piece of virus, Aracri said. If the mother has received the RSV vaccine more than two weeks before the baby is born, the baby does not need the monoclonal antibodies.

“They are recommending moms get the RSV shot prior to delivery,” he said. “If the mom did not get the RSV shot in a timely fashion, we administer (the monoclonal antibodies) at birth.”

Dr. Kultar Shergill, pediatrician at Alle Kiski Pediatrics, said that the monoclonal antibody shot is recommended specifically for babies born during RSV season.

“This one is only for kids, and it’s routine for all babies, but it’s only during RSV season. So that would be October to March,” he said. “It’s all babies born in the first RSV season of their lives.”

Babies who are high-risk, with conditions such as lung disease or cystic fibrosis, might also be recommended to get the vaccine between the ages of 9 months and 18 months, he said.

Angie Keim, a nurse at Pediatric Associates of Westmoreland’s Greensburg office, emphasized that any baby can get the monoclonal antibody shot as long as they are younger than 8 months.

“RSV is a bad cold for anybody our age, but it just seems to hit them harder when they are real young or real old,” she said.

Dr. Richard Beigi, president of UPMC Magee-Womens Hospital, said in 2023 that, for the maternal vaccine, antibodies are transferred through the mother’s placenta into the baby’s bloodstream, protecting the baby before birth. Some other vaccines, including those for influenza, pertussis, tetanus and covid, can be transferred in the same way.

“As soon as they’re born and on their own in terms of fighting pathogens, they have antibodies from mom already onboard,” Beigi said in August. He said the maternal vaccine doesn’t ward against 100% of RSV infections, but it is effective in preventing severe disease and hospitalization at a critical time for infants.

“It’s really that hospitalization and severe disease that is most devastating to babies,” he said. “(The vaccine) helps minimize the risk of babies getting really sick and requiring hospitalization.”

Previously, supply chain issues posed an obstacle to getting the monoclonal antibody treatment into pediatricians’ offices. Shergill expects parents will have less trouble getting the vaccine by the start of the next RSV season at the latest.

“It became available in October-November. There’s been a nationwide shortage,” he said. “Our office only got it for private insurance last week, and for Medicaid in January.”

“We were all planning to roll it out, and then not enough product came to market for the monoclonal antibody. The approval for the moms came out a little bit later,” said Aracri. “It was a little herky-jerky for a little bit, but everything should be very easy next year. Not as many kids will need the monoclonal antibody because the majority of moms will get the RSV vaccines.”