RSV Vaccination During Pregnancy: What to Know for the 2025–2026 Season

Why RSV matters for newborns in the U.S.

Respiratory syncytial virus (RSV) is a common virus that usually causes cold-like symptoms in older children and adults. But in babies—especially those under 6 months—it can lead to serious lower respiratory tract disease, including bronchiolitis and pneumonia.

According to the CDC, infants are at the highest risk of hospitalization from RSV, particularly in their first months of life. In most parts of the United States, RSV circulates seasonally, typically in the fall and winter, although timing can vary by region and year.

That seasonal pattern is why timing matters for prevention. The goal is to protect newborns during their most vulnerable early months, when RSV hospitalization risk is highest.

What the CDC recommends for 2025–2026

For the 2025–2026 RSV season, CDC guidance continues to recommend a single dose of Pfizer’s RSV vaccine (Abrysvo) for pregnant people who are 32 through 36 weeks’ gestation during the RSV season.

This recommendation is based on guidance from the CDC’s Advisory Committee on Immunization Practices (ACIP) and applies only within that gestational window. The vaccine is not recommended earlier in pregnancy.

The FDA approved Abrysvo for use during pregnancy specifically at 32–36 weeks’ gestation to help protect infants from birth through 6 months of age. The 32–36 week window is designed to balance two goals:

Allow enough time for the pregnant person to develop antibodies.
Ensure those antibodies cross the placenta to the baby before birth.

If a person is not vaccinated during that window, their infant may instead receive nirsevimab, a long-acting monoclonal antibody, after birth to provide protection during RSV season.

How maternal RSV vaccination works

When a pregnant person receives Abrysvo at 32–36 weeks, their immune system produces antibodies against RSV. These antibodies cross the placenta and enter the baby’s bloodstream before birth.

This process—called placental antibody transfer—is the same strategy used with Tdap vaccination during pregnancy to protect newborns against whooping cough.

The newborn is not vaccinated directly. Instead, they are born with protective antibodies that help reduce the risk of severe RSV disease during the first months of life.

Protection is strongest in the early months after birth, which aligns with the period of highest RSV hospitalization risk.

Maternal vaccine vs. infant nirsevimab: What’s the difference?

Families may hear about two RSV prevention strategies for infants:

1. Maternal vaccination (Abrysvo)

Given to the pregnant person at 32–36 weeks during RSV season.
Stimulates the parent’s immune system to make antibodies.
Antibodies cross the placenta before birth.
Infant is born with protection.

2. Infant nirsevimab

Given directly to the infant as a single injection.
Contains laboratory-made antibodies (a monoclonal antibody).
Does not stimulate the infant’s immune system.
Provides passive protection during the RSV season.

In most cases, babies receive one strategy or the other, not both. If a pregnant person receives the RSV vaccine during the recommended window, their baby generally does not need nirsevimab. If the mother was not vaccinated in the appropriate timeframe, the infant may be eligible for nirsevimab instead.

There may be special circumstances—such as certain high-risk medical conditions—where clinicians consider additional protection, but for most healthy infants, one approach is used.

What the clinical trial showed—and its limits

The FDA approval and CDC recommendation are based largely on a large randomized, placebo-controlled trial published in the New England Journal of Medicine.

In that trial, pregnant participants were randomly assigned to receive the RSV vaccine or placebo during late pregnancy. Researchers then followed their infants after birth.

Key findings:

The vaccine significantly reduced the risk of severe RSV-associated lower respiratory tract disease in infants during the first months of life.
Protection was strongest in the first 3 months after birth and remained meaningful through 6 months.

The primary benefit measured was reduction in severe disease—not total prevention of all RSV infections. Some vaccinated infants still developed RSV, but were less likely to have severe illness.

Important limitations

Protection appears strongest in early infancy and decreases over time.
The trial was not large enough to detect extremely rare adverse events.
Seasonal patterns and circulating strains can vary year to year.

Because of these limits, CDC and FDA continue post-marketing safety monitoring to track rare or unexpected outcomes as more people receive the vaccine.

Safety and side effects

In clinical trials reviewed by the FDA, common side effects were similar to other vaccines and included:

Injection site pain
Fatigue
Headache
Muscle pain

Rates of serious adverse events were similar between vaccine and placebo groups in the trial. As with all vaccines, ongoing surveillance systems monitor for rare safety signals.

The vaccine is not recommended before 32 weeks of gestation. This timing guidance reflects careful review of available safety data.

Can it be given with other pregnancy vaccines?

According to ACOG and CDC guidance, maternal RSV vaccination may be given at the same visit as:

Tdap (recommended during every pregnancy at 27–36 weeks)
Influenza vaccine
Updated COVID-19 vaccines

Coadministration is considered acceptable, though some patients may choose to space vaccines for personal comfort. Your obstetric clinician can help you plan timing if multiple vaccines are due.

Insurance coverage and cost

Under the Affordable Care Act, most private insurance plans must cover ACIP-recommended vaccines without cost-sharing when provided by an in-network provider. Maternal RSV vaccination falls under this preventive services framework.

Medicaid programs generally cover ACIP-recommended vaccines, though details can vary by state. Coverage under Medicare and employer-sponsored plans may differ based on benefit design.

Because insurance details can change, it’s wise to confirm coverage with your plan before vaccination.

If you decline maternal vaccination

If you choose not to receive the RSV vaccine during pregnancy—or if you deliver before receiving it—your infant may still be eligible for nirsevimab for RSV season protection.

Discuss options with your pediatrician or obstetric provider so a plan is in place before RSV season begins.

When to seek medical care for RSV symptoms in infants

Even with preventive strategies, RSV infections can still occur. Seek urgent medical care if a newborn or young infant has:

Rapid or labored breathing
Pauses in breathing (apnea)
Blue lips or fingernails
Poor feeding or signs of dehydration
Unusual sleepiness or difficulty waking

Early evaluation matters, especially in infants under 3 months.

What this means for families in 2025–2026

If you are 32–36 weeks pregnant during RSV season, you may be eligible for a one-time RSV vaccine to help protect your newborn during the months when hospitalization risk is highest.

Maternal vaccination and infant nirsevimab are two different, evidence-based strategies. Most babies need one or the other—not both. Protection is strongest in the early months of life.

Talk with your obstetric clinician about timing, insurance coverage, and how RSV prevention fits into your overall pregnancy care plan. For families welcoming a baby during RSV season, planning ahead can reduce stress and help protect your newborn when they are most vulnerable.

Sources

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.