Immunizations to Protect Infants

What to know

  • CDC recommends all babies be protected from severe RSV by one of two immunization options: A maternal RSV vaccine given to the mother during pregnancy or an RSV antibody given to your baby. Most babies do not need both.
  • The maternal RSV vaccine (Pfizer's Abrysvo) is given during weeks 32 through 36 of pregnancy. Maternal antibodies protect the baby against RSV for approximately 6 months after birth.
  • An RSV antibody (nirsevimab) can be given to babies and some young children. This antibody provides immediate protection against RSV and lasts at least 5 months.
Sleeping baby lying in bed, with mother holding baby's face

Overview

Maternal RSV vaccine (Pfizer's Abrysvo)

The maternal RSV vaccine (Pfizer’s Abrysvo) is recommended if you are between 32 and 36 weeks pregnant during September through January in most of the U.S. Like other vaccines, the RSV vaccine teaches your immune system to fight disease. Even though you are not at high risk for severe RSV, this vaccine is important because you will pass the protection to your baby. From the time you are vaccinated, it takes two weeks to develop protection (antibodies) and for protection to pass on to your baby.

Protection will last during your baby’s first 6 months, while they are at highest risk of severe RSV.

If you have already received a maternal RSV vaccine during any previous pregnancy, CDC does not currently recommend you get another dose of RSV vaccine when you are pregnant again. Instead, your baby should receive nirsevimab.

RSV antibody (nirsevimab) for babies

An RSV antibody (nirsevimab) is recommended for all babies younger than 8 months of age born to mothers who did not receive a maternal RSV vaccine (Pfizer’s Abrysvo) during pregnancy. A nirsevimab dose should be given to babies shortly before the RSV season, or within 1 week after birth if born during October to March in most of the U.S.

Nirsevimab is also recommended for a small group of young children 8 through 19 months of age who are at increased risk for severe RSV. This nirsevimab dose should be given shortly before the child’s second RSV season. This group includes:

  • Children who were born prematurely and have chronic lung disease
  • Children with severe immunocompromise
  • Children with severe cystic fibrosis
  • American Indian and Alaska Native children

Comparison of Immunizations

Maternal Vaccine
(Pfizer’s Abrysvo)
Nirsevimab
Who is it recommended for? People who are 32 through 36 weeks pregnant Babies born to mothers who did not get a maternal RSV vaccine and, also, a small group of young children (ages 8-19 months) at increased risk of severe RSV
How does it work? Mom passes protection (antibodies) to baby during pregnancy Baby receives protection (antibodies) directly
When is it recommended in most of continental U.S.? September – January October – March
Who does it protect from severe RSV? Baby Baby
How long does protection last? Approximately 6 months after birth At least 5 months after immunization
Who should not get it? People with a history of severe allergic reaction to any component of the vaccine Children with a serious allergic reaction to any component of nirsevimab
OR
Babies who are already protected because their mother received a maternal vaccine during pregnancy
Possible side effects Common side effects: headache, nausea, pain at injection site, and more.
Possible risks under further study: preterm birth, pre-eclampsia (a dangerous high blood pressure condition)
Side effects are usually mild and end quickly.
Hypersensitivity reactions are uncommon but have been reported.
Report adverse events to: VAERS or call 1-800-822-7967 FDA’s Medwatch or call 1-800-FDA-1088

Want to learn more about immunization safety?‎

For more information about immunization safety and safety monitoring of the maternal RSV vaccination and the RSV antibody (nirsevimab), please visit Respiratory Syncytial Virus (RSV) Vaccine Safety.

Timing of Immunization to Protect Infants

CDC recommends RSV immunizations during specific months to maximize protection during RSV season.

It is important for your baby to have protection before RSV season. RSV typically peaks between December and January.

RSV vaccine (Abrysvo) recommended during week 32-36 of pregnancy: September through January. Nirsevimab recommended for infant: October through March. Immunizations are not recommended to protect infants outside of RSV season. Infants born between April through September should receive nirsevimab in October.

*Applies to most of the continental United States. Timing of Administration for RSV immunization may differ in certain areas.

How do I pay for RSV immunizations?

Vaccines for Children (VFC) program

Nirsevimab is covered by VFC, a federally funded program that provides vaccines at no cost to children who might not otherwise be vaccinated because of inability to pay. Children 18 years and under are eligible for the VFC Program if they belong to one or more of the following groups:

  • Medicaid-eligible
  • Uninsured
  • Underinsured
  • American Indian or Alaska Native

Private health insurance

Many private health insurance plans cover nirsevimab and most cover the maternal RSV vaccine, but there may be a cost to you depending on your plan. Contact your insurer to find out.

Medicaid

As of October 1, 2023, most people with coverage from Medicaid and the Children's Health Insurance Program (CHIP) will be guaranteed coverage of all vaccines recommended by the Advisory Committee on Immunization Practice at no cost to them.