Why I Recommend the RSV Vaccine to My Pregnant Patients

Every fall and winter, RSV is high on the minds of families with young children and the doctors who care for them.

That includes me and my family. I’m an ob-gyn who studies infectious diseases and cares for women before, during, and after pregnancy. I’m also the mom of two daughters and the proud grandmother of a one-year-old boy.

Thankfully, this year we have new ways to help prevent sickness with RSV, or respiratory syncytial virus, in babies and young children. In August 2023, the U.S. Food and Drug Administration (FDA) approved the Pfizer RSV vaccine for use during pregnancy. This means we can give pregnant women a vaccine that can help protect their babies from RSV after birth.

If you’re pregnant, here are the top things I want you to know about the RSV vaccine.

RSV can be serious for babies and young children.

RSV is a highly contagious virus that spreads through close contact. In most adults, RSV symptoms usually resemble those of the common cold. This is also true during pregnancy—the infection doesn’t tend to be a big deal.

But RSV is far more dangerous for babies and young children, as well as older adults. The virus can cause serious respiratory illness in these groups. In fact, it is the leading reason infants are hospitalized in the United States.

You may have heard the saying, “An ounce of prevention is worth a pound of cure.” We should do everything we can to protect babies from RSV, and that’s why the vaccine is so important.

The RSV vaccine is very good at preventing illness.

When you get the RSV vaccine, your body creates antibodies that pass to your fetus. This means your baby will have antibodies to protect them from RSV from the moment they are born. Protection from the vaccine lasts about 6 months after birth.

How effective is the RSV vaccine? In one study of babies born to vaccinated women, it lowered serious cases of RSV by about 70 percent.

The Pfizer RSV vaccine is safe for use during pregnancy.

The Pfizer RSV vaccine, also known as Abrysvo, has been studied in thousands of pregnancies. There are no safety concerns when the vaccine is given in the third trimester. (More on vaccine timing below.)

The side effects of the RSV vaccine are similar to those of other vaccines. Side effects may include pain at the injection site, headache, muscle pain, and nausea. These side effects are usually not a cause for concern.

Note: Abrysvo is the only RSV vaccine approved for use in pregnancy. Not all doctors’ offices and pharmacies have Abrysvo yet. You can search for pharmacies that have the vaccine on the Abrysvo website: www.abrysvo.com/find-a-vaccine.

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You can get the vaccine if you will be 32 to 36 weeks pregnant during RSV season.

RSV is a seasonal virus like the flu. In most of the United States, RSV season lasts from September to January. Your ob-gyn should recommend the RSV vaccine if you expect to give birth during or right before this time.

The FDA approved the vaccine for 32 to 36 weeks of pregnancy to give the body enough time to create antibodies before giving birth. If you are at high risk for preterm birth, ask your ob-gyn about the best time to get the vaccine.

You can combine the RSV vaccine with other vaccines.

It’s OK to get your RSV vaccine at the same time as other vaccines. Check with your ob-gyn to see which of the vaccines they might be able to give you at the same time, including flu, Tdap, and COVID-19. If you need to get your vaccines from a pharmacy, call ahead to see which ones are available when you go.

There’s another way to protect your baby from RSV.

It’s possible you won’t get the RSV vaccine during the recommended time. Maybe it was hard to find in your area or you didn’t hear about the vaccine during 32 to 36 weeks of your pregnancy.

In these cases, your newborn may be able to get a dose of nirsevimab before you leave the hospital or birth center. Nirsevimab is a shot containing lab-made antibodies that protect against RSV. It is not a vaccine, but it helps your baby build immunity against the virus.

Both the vaccine during pregnancy and nirsevimab after birth are safe, effective options for protecting your baby from RSV. In most cases, you should choose one or the other. You can talk with your ob-gyn about both options and whether nirsevimab is available in your area—there is currently a limited supply.

Keep your pediatrician in the loop.

Whether you get the RSV vaccine or your newborn gets nirsevimab, be sure to tell your pediatrician. They should keep track of how and when your baby gets protection against RSV. This way, your baby won’t get an extra shot that they don’t need. (Though there are no safety concerns if that happens. The concern is just about cost and limited resources.)

Questions are welcome.

As an ob-gyn and a mom, I’m overjoyed that we now have two great options for protecting babies from RSV. If you’ll be giving birth during RSV season, talk with your ob-gyn or midwife about the RSV vaccine and nirsevimab. It’s normal to have questions, and they can help you decide which option is right for you.

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This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.