What’s New With RSV, COVID-19, and Flu Shots for Kids

As children are back in school and the days get chillier, it’s a reminder to protect our families against viruses this upcoming season.

For the first time this fall, babies in the United States will have access to shots to protect against a virus that surged across the country last winter: respiratory syncytial virus, or RSV. Everyone over 6 months of age will also be able to get updated shots to protect against COVID-19 and influenza.

RSV is one of the most common causes of childhood respiratory illness and the leading cause of hospitalization among babies in the U.S. According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 80,000 children younger than 5 years old, most of them babies, are hospitalized each year due to RSV infection, with some requiring oxygen, IV fluids, or mechanical ventilation. In late 2022, a surge of RSV infections overwhelmed hospitals with babies and young kids who hadn’t been exposed to the virus during the COVID-19 lockdown.

Roshni Mathew, MD, and Hayden Schwenk, MD, pediatric infectious diseases specialists at Stanford Medicine Children’s Health, answer questions that parents have about the monoclonal antibody shot for RSV and other vaccines that are important to get heading into respiratory virus season.

RSV antibody shot to protect babies and kids

In California, RSV season typically runs from November through March. There are two monoclonal antibody products approved for use in infants and children: nirsevimab (Beyfortus) and palivizumab (Synagis).

• Nirsevimab is recommended for all infants younger than 8 months born during or entering their first RSV season. It is also recommended for some children between the ages of 8 and 19 months who are at high risk of RSV illness, like those who are severely immunocompromised and who are entering their second RSV season. One dose of nirsevimab is expected to protect infants for at least 5 months, which is about the length of an average RSV season.
• Palivizumab is approved for children under 24 months of age with certain conditions that place them at high risk for severe RSV disease. This must be given once a month during RSV season.

Antibodies are part of our immune system and help us fight infections. Monoclonal antibodies are made to look like the antibodies produced in the human body and mimic the immune system response.

“These shots are an important tool to protect our children against the threat of RSV,” Dr. Schwenk says. “For a very young infant, this method of protection is an advantage. The shots contain ready-made antibodies, which means they start working as soon as they’re given.”

An updated COVID-19 vaccine for the fall and winter

While the global COVID-19 pandemic has been declared over, the nation is seeing more cases as fall begins. The CDC is recommending an updated COVID-19 vaccine for everyone 6 months and older.  

“COVID is still very much in circulation and will likely have an uptick during the winter months,” Dr. Mathew says. “That’s why it’s still important to check in with your child’s pediatrician to see what they need to protect themselves against potentially serious outcomes of illness.”

Even if your child has recently been infected with COVID, the shots still provide additional protection. Updated COVID vaccines are designed to target the variants currently circulating.

“From the experience over the past few years, we know that one can get reinfected with COVID-19,” Mathew adds. “COVID vaccines have been shown to provide the most long-lasting protection, both in people who have and who have not had COVID infection previously.”

The vaccine requirement depends on the child’s age and how many COVID-19 vaccines they’ve already received. It’s important to check with your child’s pediatrician to see what they need to be up to date.

Protecting your child from the flu

The influenza virus changes constantly, so vaccines are updated every season. Additionally, protection from influenza vaccine declines over time, which makes it important to get the flu shot every year.

“It’s especially important for children 6 months and older to get the flu shot,” Dr. Mathew says. “Children younger than 5 years old, and especially those under 2, are at higher risk of influenza-related complications. Infants younger than 6 months are at highest risk for hospitalization, but there are no approved vaccines for this age group. It is thus important for their caregivers and other members of the household to be vaccinated as well as take other preventative actions to protect this vulnerable population.”

Parents can start by asking their child’s pediatrician, who may offer these vaccines in their office. Additionally, many local pharmacies are expected to provide COVID, flu, and RSV shots. Other than shots, some ways to protect against acquiring RSV and other respiratory viruses include washing hands, avoiding close contact with anyone who is sick, wearing a mask, and cleaning commonly touched surfaces.