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While pregnant with her third child last year, Alison Carroll pondered options that hadn’t been available during her first two pregnancies: not one but two ways to help prevent her newborn from ending up in the hospital, fighting for breath because of a severe infection with respiratory syncytial virus (RSV).

A pediatric hospitalist herself, she already had for years witnessed and treated the worst of RSV’s ravages in children, including a scary situation that landed her own daughter, Stella, in the same wing of Vanderbilt Children’s Hospital in Nashville, where Carroll works.

So Carroll didn’t need to think long before saying yes to one of the new preventative options that have revolutionized the medical world’s ability to prevent the most severe symptoms of RSV, especially in infants, who are particularly vulnerable. Since they debuted in 2023, the preventatives—a vaccine for pregnant people and an antibody shot for newborns—have reduced hospitalizations of the youngest babies by up to half.

“That’s amazing,” says Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “It actually caused a slight decrease in the infant mortality rate in this country,” a figure that wasn’t more dramatic, mainly because RSV is responsible for a small proportion of infant deaths relative to other causes.

Although the infant mortality rate is low, respiratory syncytial virus is the leading cause of hospitalization among infants in the U.S., with newborns up to the age of two months being at the highest risk, according to the U.S. Centers for Disease Control and Prevention. Roughly 60,000 to 80,000 children under age five are hospitalized with RSV every year in the U.S., and an estimated 100 to 300 children in that age group die annually.

In some babies, RSV progresses beyond cold-like symptoms, spreading from the upper respiratory tract (primarily the nose and throat) to the lower, where it affects their lungs and ultimately causes severe breathing difficulties, low oxygen levels and other serious complications.

That’s why pediatricians and infectious disease specialists have reacted with such enthusiasm to the development of the preventative measures, which, in both clinical trials and early real-world results, have produced dramatic reductions in RSV infections that require medical attention or hospitalization among babies. A CDC analysis of data from two different groups of children in the U.S. found that RSV-related hospitalization rates among infants seven months and younger decreased by about 28 and 43 percent, respectively, during the peak of the 2024–2025 RSV season, when both preventatives were available, compared with pre-COVID-pandemic RSV seasons from 2018 to 2020.

Looking at the data more narrowly, the researchers saw an even larger effect: for infants aged zero to two months, the decreases were 45 percent and 52 percent for the two groups, respectively. That 45 percent reduction jumped to 71 percent when the Houston, Tex., region was excluded because of its early-onset RSV season, which began before the new drugs were available.

Offit says the CDC data were not limited to babies who received antibodies through the maternal vaccine or monoclonal antibody injections but rather included all RSV-related infant hospitalizations. “This wasn’t an efficacy study,” he says. “They were looking from 30,000 feet, saying, ‘Has there been a decrease [in hospitalizations]?’”

“And there has,” he adds, “which is remarkable.”

Offit isn’t the only expert offering superlatives.

“I think the results have been stunning, actually,” says Yvonne Maldonado, chief of pediatric infectious diseases at Stanford University School of Medicine and a former member of the federal Advisory Committee on Immunization Practices. “Those two treatments, or preventive measures, have resulted in massive reductions in infections and, among infected kids, massive reductions in hospitalizations.”

The protective measures work in different ways. With an injection of the Pfizer vaccine Abrysvo at 32 to 36 weeks of gestation, a pregnant person develops antibodies against RSV that are conferred to the fetus through the placenta, giving babies crucial protection that lasts for the first six to nine months of life.

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Chiara Vercesi

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