Vaccination against RSV during pregnancy

How does it work?

You’ve probably heard about the RSV virus in the news. It’s a virus that causes severe respiratory infections in young babies, sometimes leading to hospitalization. RSV is most common during the winter months. A recently approved antibody injection (nirsevimab) is now available for babies. Additionally, there is a vaccine against RSV that can be administered to pregnant women during pregnancy. Here’s what you need to know.

1 in 56 healthy babies hospitalized due to RSV

Approximately 44% of babies contract RSV within their first year. Most children recover within 3-7 days. By the age of two, most children have been infected with RSV at least once and have developed antibodies. It is possible to be infected multiple times. While most children experience mild cold-like symptoms and a cough, some babies can become severely ill—especially premature babies, children with congenital heart defects, or those with Down syndrome. These children may develop breathing difficulties due to inflammation of the small airways (bronchiolitis) or pneumonia.

Even healthy babies can become seriously ill from RSV: approximately 1 in 56 babies require hospitalization due to severe RSV symptoms. Every year, 150 to 200 babies in the Netherlands are admitted to intensive care and require ventilation. Globally, RSV is the second leading cause of infant mortality. However, deaths from RSV are rare in the Netherlands.

80% of Hospitalizations Occur in Babies Under 6 Months Old

Severe Breathing Difficulties

An RSV infection can lead to serious respiratory infections with symptoms such as coughing, nasal congestion, and difficulty breathing. The Respiratory Syncytial Virus (RSV) produces a lot of mucus in the airways. Young babies are not strong enough to clear the mucus themselves, and their airways are still very narrow. Even a small amount of mucus can cause significant breathing difficulties. That’s why parents of young babies are strongly advised to consult a doctor immediately if their child shows cold symptoms.

RSV Immunization: Injection for Babies

In early 2024, the Dutch Health Council recommended that babies under the age of one receive an antibody injection (nirsevimab) within two weeks after birth if they are born between November and March. This is a form of passive immunization, meaning that instead of stimulating the baby’s immune system to produce antibodies (as with a vaccine), the baby directly receives antibodies.

This injection provides protection for about five months. Since RSV is mainly active in autumn and winter, it is not beneficial to vaccinate babies born outside of this period right away. To ensure that babies born in spring and summer are also protected during the RSV season, the recommendation is to vaccinate them in October.

The goal is to include the RSV shot in the Dutch National Immunization Program from autumn 2025, offering it to all children in their first year of life.

RSV vaccine for pregnant women

Another way to protect babies against RSV is by vaccinating pregnant women with the Abrysvo vaccine. This vaccine should be administered between 24 and 36 weeks of pregnancy, with a preference for around 30 weeks. It works similarly to the 22-week whooping cough vaccine: the mother receives small protein fragments from the RSV virus, which trigger her immune system to produce antibodies. These antibodies are transferred to the baby through the placenta, providing protection from birth. The baby is protected approximately two weeks after the mother receives the vaccine.

However, if a baby is born prematurely (before 32 weeks), the mother’s vaccination may not provide sufficient protection, as there is less time for antibody transfer. In such cases, the baby may still need additional immunization. For this reason, the Dutch Health Council currently prefers direct immunization for babies over vaccinating pregnant women.

Effectiveness of RSV Immunization and Vaccination

Both RSV immunization for babies and RSV vaccination for pregnant women are expected to prevent many hospitalizations. Studies show that providing antibodies to babies carries minimal risk, with possible mild side effects such as redness, tenderness at the injection site, or mild fever. This treatment is already given to highly vulnerable babies in hospitals with very few side effects reported.

For pregnant women, reported side effects of the RSV vaccine include pain at the injection site (41%), headache (31%), and muscle pain (27%). No adverse effects have been observed in babies whose mothers were vaccinated during pregnancy.

Not Yet Part of the National Immunization Program, But Funding Approved

Currently, the Dutch Health Council has only issued recommendations for RSV immunization in babies and vaccination during pregnancy. Both have been approved, but they are not yet included in the National Immunization Program. However, the Dutch government has allocated funding for their implementation. The Dutch National Institute for Public Health (RIVM) is now investigating when and how these vaccinations will be administered.

Where Can Pregnant Women Get the RSV Vaccine?

Pregnant women can receive the RSV vaccine at most general practitioners (GPs) and municipal health services (GGDs). These providers can order the vaccine and administer it.

Additionally, the Stadskliniek offers the RSV vaccine by appointment. Stadskliniek is a private clinic specializing in preventive care, including travel vaccinations and sexual health. In collaboration with Verloskundigen Amsterdam Zuid, Stadskliniek provides the maternal RSV vaccine for pregnant women at the following locations:

Amsterdam – Westeinde 4, 1017 ZN (Opposite the National Bank)
Amstelveen – Handelsweg 59 bg, 1181 ZA

Appointments can be scheduled by phone at 085 065 7672 or online via their website:
https://stadskliniek-vaccinaties.nl/rs-virus-vaccinatie/

Cost of the RSV Vaccine

Since the government has not yet allocated funds for this vaccine, pregnant women must pay for it themselves. The vaccine costs approximately €230. Additionally, there is a consultation and administration fee of around €50, but the exact cost may vary depending on the healthcare provider.

Want to Learn More? Ask Your Midwife!

If you have questions about the RSV vaccine—whether for yourself during pregnancy or for your baby—you can ask your midwife for more information. They can keep you updated on the latest developments and answer any questions.

For up-to-date information, visit the RIVM website:
www.rivm.nl/rs-virus