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Respiratory Syncytial Virus (RSV)

RSV Immunization

Everyone ages 75 and older should get an RSV vaccine if they have not received one before. People ages 50 to 74 who are at high risk of severe RSV who have not received an RSV vaccine before should get vaccinated as well.

To protect infants, either pregnant people should get an RSV vaccine, or infants born during or entering their first RSV season should get a monoclonal antibody medicine.

To find an RSV vaccination site, talk to your doctor, visit the NYC Health Map, or call 311.

See detailed respiratory virus season vaccination recommendations from the American Medical Association.


Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms but may result in severe illness in some people. RSV is the leading cause of hospitalization among infants in the United States.

RSV is very contagious. The virus can spread when:

  • A person who has RSV coughs or sneezes and the infected droplets enter your eyes, nose, or mouth
  • You touch a surface that has the virus on it, like a counter or doorknob, and then touch your face before washing your hands
  • You have direct contact with the virus, like kissing the face of a child with RSV

RSV can spread year-round but is more common in the fall and winter months.

Symptoms

Symptoms usually begin four to six days after exposure and develop gradually over several days. People are usually contagious for three to eight days and can be contagious before symptoms start. Most people recover in one to two weeks, though coughs can last for a few days to several weeks. In some cases, particularly with infants and those with a weakened immune system, people can continue to spread the virus for four weeks or longer, even if they no longer have symptoms.

Symptoms of RSV often include:

  • Runny nose
  • Sneezing
  • Cough
  • Congestion
  • Chills
  • Low fever
  • Loss of appetite

In very young infants with RSV, the only symptoms may be irritability, decreased activity, decreased appetite, and breathing difficulties.

RSV infection can cause pneumonia, especially in people at increased risk of severe RSV.

The symptoms of RSV can be similar to symptoms of other respiratory illnesses, such as COVID-19, flu, and the common cold, as well as some illnesses caused by bacteria. Healthcare providers may recommend RSV and other diagnostic tests.

People at Risk of Severe Illness

While anyone can be infected with RSV, it is more likely to cause severe illness and complications in:

  • Infants, especially those born premature and those six months and younger
  • Children younger than two years old with chronic lung disease or congenital (present from birth) heart disease
  • Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus
  • Adults 75 years and older
  • Adults ages 50 to 74 with underlying medical conditions, including people with:
    • Chronic heart or lung disease
    • A weakened immune system
  • People living in a nursing home or other long-term care facility

It is possible to get RSV again after recovering from an RSV infection.

Prevention

Everyone can decrease the risk of getting and spreading RSV and other respiratory viruses:

  • Get vaccinated if you are eligible.
  • Cover your coughs and sneezes with a tissue or your arm.
  • Wash your hands often. Use hand sanitizer when soap and water are not available. Remind and help children to wash their hands.
  • Stay home when sick and keep children who are sick home from school and day care. Avoid close contact with people at increased risk for severe infection, such as infants and older adults, when you are sick.
  • Clean frequently touched surfaces, especially if someone in the household is sick.
  • Avoid close contact with people who are sick, especially if you are at increased risk for severe infection.
  • Consider wearing a face mask, especially if you are at increased risk of severe illness or around others who are.

Some young children at high risk for severe RSV should receive monoclonal antibody medicine during their second RSV season.

Vaccination

People Ages 50 and Over

There are three RSV vaccines available (Arexvy, Abrysvo, and mResvia).

Unlike with COVID-19 and flu, you only need to get vaccinated against RSV once. If you previously got an RSV vaccine you should not get vaccinated again. The following groups who have never received an RSV vaccine should get vaccinated:

  • People age 75 and older
  • People age 50 to 74 who are at increased risk for severe RSV due to an underlying medical conditions (such as chronic heart or lung disease or a weakened immune system) or live in a nursing home or other long term care facility

Talk to your health care provider about whether RSV vaccination is right for you.

Infants and Young Children

All infants should be protected from RSV. There are two options to protect an infant from RSV during their first RSV season. Either the parent can get an RSV vaccine during pregnancy (before the baby is born), or the baby can get a monoclonal antibody medicine before they are 8 months old.

  • Pregnant people can get a vaccine (Abrysvo) during 32 to 36 weeks of pregnancy and between September 1 and March 1. Pregnant people who got an RSV vaccine during a prior pregnancy should not get vaccinated again.
  • If the parent who gave birth was not vaccinated during the current pregnancy, infants younger than 8 months old born during or entering their first RSV season (typically October 1 to March 31) should get a monoclonal antibody medicine (nirsevimab or clesrovimab).
  • In most cases, only one option (vaccination of the pregnant parent or monoclonal antibody medicine given to the infant) is needed to protect the infant.
  • Expectant parents should discuss which option is right for them with their provider.

Some young children 8 through 19 months old who are at increased risk for severe RSV should get a monoclonal antibody medicine (nirsevimab) to protect against severe RSV during their second RSV season.

This includes children who:

  • Were born prematurely (less than 32 weeks' gestation)
  • Have chronic lung disease
  • Are severely immunocompromised
  • Have severe cystic fibrosis
  • Have Down syndrome or other chromosomal differences
  • Are American Indian or Alaskan Native

Talk to your child’s health care provider if you think your child may need monoclonal antibody medicine.

People Who Are Immunocompromised

People age 18 and older, and some people younger than 18, who have a weakened immune system should get vaccinated. Talk to your or your child’s provider if you think you think this may apply to you or them.


Find an RSV Vaccine

Treatment

There is no routinely recommended treatment for RSV infection. If you or your child has severe symptoms that might be caused by RSV, seek medical attention. Health care providers can provide supportive care.

If you do not have a health care provider, call 311 or 844-NYC-4NYC (844-692-4692) to be connected to NYC Health + Hospitals. Care is available in NYC regardless of immigration status, insurance or ability to pay. If it is an emergency, call 911 or go to the hospital.

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