WHO recommends new Immunizations guidelines to shield infants from deadly RSV

SWITZERLAND—The World Health Organization (WHO) has released its first-ever position paper on immunization products designed to protect infants from respiratory syncytial virus (RSV), a leading cause of severe respiratory infections in young children worldwide.

RSV is responsible for approximately 100,000 deaths and over 3.6 million hospitalizations annually among children under five years old.

Alarmingly, about half of these deaths occur in infants younger than six months, with 97% of fatalities happening in low- and middle-income countries where access to medical support like oxygen and hydration is limited.

The WHO’s position paper, published in the Weekly Epidemiological Record, provides recommendations for two key immunization options: a maternal vaccine administered to pregnant women during their third trimester, and a long-acting monoclonal antibody given to infants from birth or shortly before the RSV season begins.

These recommendations aim to reduce the burden of severe RSV disease by preventing infections in the most vulnerable age groups.

Dr. Kate O’Brien, WHO’s Director of Immunization, Vaccines, and Biologicals, emphasized the high contagiousness of RSV and its particular danger to infants, especially those born prematurely.

She highlighted that the newly recommended immunization products have the potential to significantly lower hospitalizations and deaths caused by RSV, ultimately saving many infant lives globally.

RSV typically causes mild symptoms similar to a common cold, such as a runny nose, cough, and fever.

However, it can escalate to serious conditions like pneumonia and bronchiolitis, especially in infants, young children, older adults, and people with weakened immune systems or existing health issues.

In response to the global impact of RSV, WHO advises all countries to introduce either the maternal vaccine, RSVpreF, or the monoclonal antibody, nirsevimab, based on factors such as feasibility within existing health systems, cost-effectiveness, and expected coverage.

Both products were endorsed by WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) for worldwide use in September 2024.

Furthermore, the maternal vaccine received WHO prequalification in March 2025, enabling its procurement by United Nations agencies.

The maternal vaccine is recommended for pregnant women from week 28 of pregnancy onward to ensure effective transfer of protective antibodies to the infant.

It can be administered during routine antenatal care visits, including any of the five WHO-recommended visits in the third trimester.

Nirsevimab, the monoclonal antibody, is given as a single injection that begins protecting infants within a week and lasts for at least five months, covering the entire RSV season in countries where the virus is seasonal.

WHO suggests giving this injection to newborns before hospital discharge or during their first health visit.

If a country opts to administer it seasonally rather than year-round, older infants can receive the dose just before their first RSV season.

The greatest benefit is seen in infants under six months, though protection may extend up to 12 months.

WHO regularly updates position papers on vaccines and immunization products to guide large-scale vaccination programs.

This new paper aims to assist national health policymakers, immunization managers, and funding bodies in making informed decisions about incorporating RSV immunization products into their health systems, ultimately improving child health outcomes worldwide.

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