RSV Infections: Protecting Infants and Older Adults from Serious Respiratory Illness

Every year, as winter settles in, a quiet but dangerous virus begins to spread - one that might seem like just a cold to healthy adults but can turn deadly for babies and older people. This is RSV - Respiratory Syncytial Virus. It’s not new, but in 2026, we have better tools than ever to fight it. And if you’re caring for a newborn, an elderly parent, or someone with health issues, knowing what RSV does and how to stop it could mean the difference between a few days at home and a hospital stay.

What RSV Actually Does to the Body

RSV starts like a common cold: runny nose, cough, low fever, sore throat. But for some, it doesn’t stop there. The virus attacks the small airways in the lungs, causing swelling and mucus buildup. In infants, those airways are tiny - as narrow as a straw. When they get blocked, breathing becomes hard, fast, and shallow. You might see the ribs pulling inward with each breath, or notice the baby struggling to feed because they can’t breathe and suck at the same time.

In older adults, RSV doesn’t just cause lung problems - it pushes already weakened systems over the edge. Someone with heart failure or COPD might find their condition suddenly worse. Their oxygen levels drop. They get more tired. Their heart works harder. For many, this isn’t just an infection - it’s a trigger for a medical crisis.

The virus spreads easily. It lives on doorknobs, toys, and phones for hours. A single sneeze can send it flying through the air. Kids pick it up at daycare. Grandparents catch it from a grandchild who doesn’t feel sick yet but is already shedding the virus. That’s why RSV peaks between December and January - when people are indoors, close together, and the air is dry.

Why Infants Are at the Highest Risk

Babies under 6 months are the most vulnerable. Their immune systems haven’t learned to fight this virus yet. About 2 to 3% of all infants under 6 months will end up in the hospital because of RSV. That’s roughly 60,000 children in the U.S. every year. Premature babies, those born before 29 weeks, are three to five times more likely to need intensive care. Babies with heart defects or chronic lung disease face even higher risks - up to 20 times more likely to get seriously ill.

Symptoms in infants aren’t always obvious. They might not have a fever. Instead, they become unusually quiet, stop eating, or breathe so fast you can count each one. Their lips or fingernails might turn blue. If you see any of this, don’t wait. Call your doctor immediately.

The long-term effects can last years. Kids who were hospitalized with RSV before age 2 are more than four times as likely to develop wheezing or asthma by age 7. Studies show their lung function stays lower than peers’ well into adolescence. This isn’t just about surviving the infection - it’s about protecting their future breathing.

Older Adults Are Being Hit Harder Than Ever

For decades, RSV was seen as a child’s illness. That changed in the last five years. Now we know: older adults are in serious danger. Each year, RSV sends 60,000 to 160,000 adults over 65 to the hospital in the U.S. and kills between 6,000 and 14,000 of them.

The risk isn’t just about age. It’s about what else is going on in the body. Adults with COPD are over four times more likely to be hospitalized. Those with heart failure face nearly three times the risk. People over 75 stay in the hospital longer - nearly a week on average - and are nearly twice as likely to die from it.

What’s worse? RSV often makes existing problems worse. Three out of four hospitalized older adults see their heart or lung condition get significantly worse. Nearly one in three ends up in the ICU. And after recovery, 42% struggle with basic tasks like bathing or dressing. One in four need to move to a rehab center or nursing home - something they didn’t need before getting sick.

The Game-Changing Tools Now Available

For the first time in history, we have real ways to prevent severe RSV - not just treat it.

For babies: A single shot called nirsevimab (Beyfortus™) was approved in mid-2023. It’s a monoclonal antibody - a lab-made protein that gives immediate, temporary protection. One dose lasts five months, covering the entire RSV season. It reduces the chance of hospitalization by 75%. The CDC now recommends it for all infants under 8 months entering their first RSV season. High-risk toddlers between 8 and 19 months also get it before their second season.

For older adults: Two vaccines came out in 2023. GSK’s Arexvy and Pfizer’s Abrysvo. Both are given as a single shot. Arexvy cuts severe lower respiratory disease by over 82%. Abrysvo cuts it by 67%. These aren’t perfect - but they’re the best protection we’ve ever had. The CDC advises adults 60 and older to talk with their doctor about getting vaccinated, especially if they have heart or lung disease, live in a nursing home, or have other chronic conditions.

For pregnant people: Abrysvo is also approved for use during weeks 32 to 36 of pregnancy. When a mother gets the vaccine, her body makes antibodies that pass to the baby through the placenta. This protects the newborn from birth through the first six months - a critical window when babies are most vulnerable and can’t yet get their own shots.

What You Can Do Right Now

Even with new tools, prevention still starts with simple habits - especially in homes with babies or older adults.

• Wash hands with soap for at least 20 seconds before touching a baby or an elderly person. Use hand sanitizer if soap isn’t available.
• Avoid kissing babies on the face. Even if you feel fine, you could be carrying the virus.
• Keep high-touch surfaces clean - doorknobs, light switches, phones, toys. Use an EPA-approved disinfectant that kills RSV.
• If someone in the house has a cold, wear a mask around infants and older adults. Keep them separated if possible.
• Don’t take babies to crowded places during peak RSV season (late fall to early spring). Avoid daycare if you can, especially for premature infants.
• Make sure older adults get their flu shot and pneumococcal vaccine. These won’t stop RSV, but they reduce the chance of other infections that can make RSV worse.

The Bigger Picture: Why This Matters Beyond Your Home

RSV doesn’t just hurt families - it strains the whole health system. In the U.S., it costs $1.7 billion in direct medical bills each year for children under five. When you add lost work time, caregiving, and long-term care, the total hits $7.8 billion.

Globally, the gap is even starker. Over 97% of RSV deaths in children under five happen in low- and middle-income countries. In rural Kenya, one in 40 infected babies dies. In remote parts of Papua New Guinea, it’s one in six. The reason? No oxygen, no ventilators, no access to monoclonal antibodies or vaccines.

The tools we have now - nirsevimab, the vaccines - are life-saving. But they’re expensive. Arexvy costs $295 per dose in the U.S. In many countries, that’s more than a month’s income. Until these tools become affordable and widely available, RSV will keep killing children who don’t need to die.

What Comes Next

Research is moving fast. New antivirals like ALS-8176 are showing promise in trials, cutting viral load by 97%. Maternal vaccination is now a standard recommendation, and we’re learning how to better protect premature babies. By 2030, experts believe these tools could prevent up to 600,000 hospitalizations worldwide.

But progress won’t be complete until access is fair. Protecting infants and older adults isn’t just about medicine - it’s about justice. Every child deserves a chance to breathe. Every older adult deserves to stay safe in their own home.

If you’re a parent, grandparent, or caregiver - you’re not alone. Talk to your doctor. Ask about nirsevimab for your baby. Ask about the RSV vaccine for yourself or your loved one. Use the tools we have. And never ignore signs of trouble in a baby’s breathing or an older person’s sudden decline.

RSV is still out there. But now, we have the power to stop it.