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Respiratory Syncytial Virus (RSV) Prevention Program

Clinician giving young child vaccination shot

The CHOC respiratory syncytial virus (RSV) prevention program provides monthly palivizumab (Synagis®) injections to infants and young children who are at high risk of hospitalization if they become infected with RSV.

Our 24/7 free nurse helpline can address questions about your
child’s health and answer questions about RSV prevention.

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CHOC offers the only specialized RSV prevention program in Southern California with access to a full team of board-certified physicians, specialized pediatric nurse practitioners and a care coordinator. Learn more about RSV.

The CHOC Difference

  • We offer the only specialized RSV prevention program in Southern California.
  • RSV patients have access to a full team of board-certified physicians and specialized pediatric nurses.
  • Our RSV program provides integrated services from a multitude of physicians, such as pulmonologists, cardiologists, gastroenterologists, endocrinologists and more.
  • RSV patients are assigned a care coordinator who will help obtain insurance authorizations, schedule appointments, send reminders and follow-up with you regarding your child’s health.
  • Your child we be examined by a specialized nurse practitioner at every appointment. The medical assistant will then administer the injection and provide education regarding aftercare.
  • The RSV prevention program is designed to complement the services of your child’s primary care physician and other specialists by providing supplementary care.
  • CHOC provides patient- and family-centered care to our patients and families to meet the needs of your child in the best way possible.
  • We have the most comprehensive child life program in the region.

Respiratory Syncytial Virus (RSV)

What is respiratory syncytial virus (RSV)?

RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lungs) and pneumonia in babies. It is an illness that often occurs in yearly outbreaks in communities, school classrooms, and day care centers. In the United States, RSV is more common in winter and early spring months. Learn more about the CHOC RSV Prevention Program .

What causes respiratory syncytial virus (RSV)?

RSV is spread from respiratory secretions through close contact with infected people or contact with contaminated surfaces or objects. Infection can occur when infectious material contacts mucous membranes of the eyes, mouth, or nose, and possibly through the inhalation of droplets generated by a sneeze or cough. The incubation period (time from exposure to symptoms) is about 2 to 5 days.

Who is affected by respiratory syncytial virus (RSV)?

RSV can affect a person of any age, although severe symptoms usually only occur in very young infants. Most babies have been infected at least once by the time they are 2 years old. Babies can also be re-infected with the virus. Recurrence throughout life is common. Babies born prematurely or with heart, lung or immune system diseases are at increased risk of developing more severe illness.

Why is respiratory syncytial virus (RSV) a concern?

In babies at increased risk, infection with the virus can lead to severe respiratory illness and pneumonia, and may become life-threatening. RSV in infancy may be related to development of asthma later in childhood.

What are the symptoms of respiratory syncytial virus (RSV)?

The early phase of RSV in infants and young children is often mild, somewhat like a cold. In children younger than 3, the disease may progress into the lower airways and cause coughing and wheezing. In some, the infection progresses to a severe respiratory disease requiring hospitalization to help the child breathe.

The following are the most common symptoms of RSV. However, each baby may experience symptoms differently. Symptoms may include:

  • Runny nose
  • Fever
  • Cough
  • Apnea (periods without breathing)
  • Trouble eating, drinking, or swallowing
  • Wheezing
  • Flaring of the nostrils or straining of the chest or stomach while breathing
  • Breathing faster than usual, or trouble breathing
  • Turning blue around the lips and fingertips

The symptoms of RSV may resemble other conditions or medical problems. Always consult your baby’s doctor for a diagnosis.

How is respiratory syncytial virus (RSV) diagnosed?

Diagnosis is sometimes difficult because the symptoms of RSV can resemble other infections. Illness in other family members, other babies in the hospital nursery, or the time of year may provide clues. In addition to a complete medical history and physical examination of your child, a test (nasal swab or nasal wash) of the baby’s respiratory secretions may show the presence of a virus.

What is the treatment for respiratory syncytial virus (RSV)?

Specific treatment for RSV will be determined by your baby’s doctor based on:

  • Your baby’s age, overall health, and medical history
  • The extent of the condition
  • Your baby’s tolerance for specific medications, procedures, or therapies

There are no medications used to treat the virus itself. Care of a baby with RSV involves treating the effects of the virus on the respiratory system. Because a virus causes the illness, antibiotics are not useful, unless there is also a bacterial infection. Treatment may include:

  • Supplemental oxygen
  • Breathing treatments
  • Suctioning of mucus
  • Intravenous fluids (to prevent dehydration)
  • Tube feedings (if the baby has difficulty sucking)

Children with very serious breathing problems are intubated and put on ventilators (breathing tubes are inserted and attached to machines that assist with breathing).

What is Palivizumab (Synagis®)

Palivizumab is a monoclonal antibody recommended by the American Academy of Pediatrics (AAP) to be administered to high risk infants and young children likely to benefit from immunoprophylaxis based on gestational age, certain underlying medical conditions, and RSV seasonality. It is given in monthly intramuscular injections during the RSV season, which generally occurs during fall, winter and spring in most locations in the United States.

About Nirsevimab (Beyfortus)

Is nirsevimab a vaccine?

Nirsevimab is a monoclonal antibody product that is a passive immunization. While not technically a “vaccine” in a traditional sense (active immunization), it is being used in a manner similar to routine childhood vaccines and may be referred to as a vaccine by some entities. Nirsevimab confers long-lasting protection from RSV, with protection expected to last at least five months (about the length of a typical RSV season). Nirsevimab is part of the Vaccines for Children program.  

Who qualifies to receive nirsevimab?

  • All infants under eight months between the months of October through March who have not received it in the last five months.
  • Most infants whose mothers received RSV vaccination (like Abrysvo or the RSV prefusion F protein vaccine) 14 days prior to birth do not need Beyfortus. However, some infants who are considered high-risk for severe RSV, even if their mother got the RSV vaccine during pregnancy, may still be recommended to receive Beyfortus.
  • High risk infants 8-19 months children aged 8–19 months entering their second RSV season and belonging to the following groups:
    • Children with chronic lung disease of prematurity who required medical support (chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) any time during the 6-month period before the start of the second RSV season
    • Children who are severely immunocompromised.
    • Children with cystic fibrosis who have signs of severe lung disease (previous hospitalization for pulmonary exacerbation in the first year of life or abnormalities on chest imaging that persist when stable) or weight-for-length in <10th percentile
    • American Indian and Alaska Native children.

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