University of Vermont Medical Center Urges Pediatric RSV Immunization for Newborns and Infants

Burlington, VT – In the Pediatric Intensive Care Unit (PICU) at University of Vermont Children’s Hospital, things look different this year – specifically, fewer newborns and infants admitted in need of critical respiratory care after catching one of the season’s most aggressive respiratory viruses: Respiratory syncytial virus (RSV). 

“RSV is the most common reason for children under one year old to be admitted to the hospital,” Rebecca Bell, MD, a pediatric critical care physician at UVM Medical Center. “The kids that get the sickest are the youngest kids – particularly under six months old. Every year, our PICU is full of infants critically ill with RSV infection.” 

But this year, RSV-related hospital admissions for these youngest patients are down significantly, said Dr. Bell – and the reason is clear: A new monoclonal antibody prevention medication approved in July 2023 by the Food and Drug Administration. 

The medication, called nirsevimab, is given via injection to infants under eight months old and uses lab-made antibodies to block RSV from infecting cells. Unlike a vaccine, the immunization provides a ready-made supply of antibody protection to babies without triggering an immune system response. Protection against severe RSV infection begins immediately. 

The immunization is currently available in Vermont to all infants under eight months old. Newborns born during RSV season can receive the shot in the nursery at University of Vermont Health Network hospitals and birthing hospitals across the state, prior to going home for the first time. Any infant under eight months of age who has not received the immunization can get it at their child’s doctor’s office. Some children with underlying medical conditions that put them at risk for severe RSV disease are also eligible for immunization during their second RSV season. Parents should talk to their child’s doctor to find out more about their child’s eligibility. 

The immunizations will remain available through the end of March. That’s when RSV season typically ends, based on projections by the Centers for Disease Control and Prevention. Infants born after March will be able to receive the immunization in October, before the start of the next RSV season. 

Research published in late 2024 in the journal JAMA Pediatrics found nirsevimab was more than 90 percent effective at preventing hospitalization for RSV, and 89 percent effective at preventing all types of doctor visits for the virus. The immunization is particularly effective at preventing severe forms of RSV that require intensive care. 

Vermont and New York are among the states with the highest RSV immunization rates in the country. And this is having an immediate impact on infant hospitalizations. 

“This season looks totally different than it’s ever looked before,” said Dr. Bell. “There is a lot of RSV around, it’s just that infants aren’t becoming critically ill because they’re being immunized against it. It’s a great success story: Here’s something you can do right now to protect your infant.” 

Advances in Protection Against RSV Resonate with Parents of Previously-Ill Infants 

Kristen Bird’s 7-year-old son, Weston, is a typical boy. He loves Nerf guns, showing off his ninja skills, playing Minecraft and is, by all accounts, a burgeoning comedian at school, where he makes everyone laugh. 

Weston is also an RSV survivor who, as a three-month old infant, nearly died and still carries lingering reminders of the trauma he endured during a hospital stay that stretched to more than four weeks – much of it spent medically paralyzed and on mechanical ventilation. 

“My husband and I had a two- and a five-year-old at home and we were living in the PICU, not knowing whether we could go home, because he might die. That was the level of intensity,” said Bird, FNP, a nurse practitioner and lactation consultant who has provided pediatric care in South Burlington for nearly 13 years. 

Weston’s path to UVM Children’s Hospital’s PICU as an infant is similar to the vast majority of pediatric RSV hospital admissions. With a house full of children – Weston has two older sisters, who were ages five and two at the time -- and no immunizations against the seasonal virus available, Bird and her husband, David, did their best to keep the kids from sharing germs while carrying on with normal family life. 

But when Weston, who had already experienced serious medical issues as a newborn, came down with a second cold, Bird felt something was seriously wrong. 

“He just seemed to deteriorate in a matter of hours, in my arms,” she said. 

With Weston spiking a fever as an ambulance brought him to UVM Medical Center, he tested positive for RSV and was admitted to the PICU. 

“I remember standing in the PICU at one point and watching two [attending physicians] try to figure out what to do while Weston was crashing right in front of us,” said Bird. 

Weston’s condition would only deteriorate further: he became anemic, developed a heart murmur and displayed signs of wear-and-tear on his kidneys. As his lungs shut down, doctors decided to connect him to a special ventilator that required Weston to be medically paralyzed to prevent even minor movements. The equipment, called high-frequency oscillatory ventilation (HFOV), is typically used to manage severe lung-related conditions or as a rescue strategy when conventional mechanical ventilation fails. 

Weston remained on HFOV for 11 days. Poor weather and concerns about the risks of medical transport made it impossible to airlift him to a higher level of care.  

Bird remembers obsessively watching her son’s vital signs and periodically alerting doctors that Weston was waking up from sedation, as she saw his heart rate increase. 

“No mom should ever have to do that,” she said. 

The impacts of Weston’s time in the PICU run a wide gamut, from short- and medium-term to lingering evidence of trauma. As an infant following his recovery, Weston had residual weakness for months and dealt with a variety of developmental delays – though he bounced back from those and avoided serious, long-term developmental impacts and complications, such as needing to be on supplemental oxygen. 

Nevertheless, Bird continues to see the ordeal’s impact on her son. For years, Weston was terrified of the dark; scared of elevators and of noises like fire alarms and smoke detectors – remnants, Bird believes, of his time in the hospital. 

She urged parents of infants and newborns to take advantage of the RSV immunization, saying it provides the kind of protection she wishes had been available to Weston in his first months of life. 

 “It comes ready-made and works as soon as it goes in the body – and it protects them throughout the RSV season,” she said. “What a gift.”