Guidance

A guide to RSV vaccination for pregnant women

Published 12 July 2024

Applies to England

From 1 September 2024, pregnant women can have a free vaccine in each pregnancy, to protect their babies against respiratory syncytial virus (RSV).

RSV is a common virus which can cause a lung infection called bronchiolitis. In small babies this condition can make it hard to breathe and to feed. Most cases can be managed at home but around 20,000 infants are admitted to hospital with bronchiolitis each year in England. Infants with severe bronchiolitis may need intensive care and the infection can be fatal. RSV is more likely to be serious in very young babies, those born prematurely, and those with conditions that affect their heart, breathing or immune system.

Symptoms of RSV bronchiolitis

The symptoms of RSV bronchiolitis can include:

• runny or blocked nose
• breathing is difficult, fast or noisy (wheezing)
• difficulty feeding
• cough
• fever
• unsettled or difficult to comfort
• tiredness or lethargy

RSV can also cause other conditions in young children such as a barking cough (croup) and a painful infection inside the ear (otitis media).

Ask for an urgent GP appointment or call 111 if your child has the following symptoms

• your child has had a cold and it’s getting worse
• your child is feeding or eating much less than normal
• your child has had a dry nappy for 12 hours or more, or shows other signs of dehydration
• your baby is under 3 months and has a temperature of 38°C
• your baby is older than 3 months and has a temperature of 39°C or higher

Call 999 or go to A&E

If your child seems seriously unwell, trust your own judgement.

You should act if:

• your child is having difficulty breathing
• you may notice grunting noises or their chest and tummy wall being sucked in between or just under their ribs
• there are pauses when your child breathes
• your child’s skin, tongue or lips are blue
• your child is floppy and will not wake up or stay awake

How RSV is spread

RSV infections can occur all year round but cases peak every winter.

RSV is highly infectious and spreads easily, particularly among children, through coughing and sneezing. Even with simple measures such as hand-washing and covering your mouth and nose when you sneeze, it is difficult to avoid spreading the infection within the family. The best way to protect your baby against RSV infection is for you to have the vaccine during pregnancy.

How the RSV protects your baby

The vaccine boosts your immune system to produce more antibodies against the virus. These antibodies then pass through the placenta to help protect your baby from the day they are born. RSV vaccination reduces the risk of severe bronchiolitis by 70% in the first 6 months of life. After this age your baby is at much lower risk of severe RSV.

Older children and adults can also get RSV infection, but the disease is more serious for small babies and people aged 75 and over.

The vaccine has been shown to reduce the chance of your baby suffering from severe RSV disease. Like all medicines, no vaccine is completely effective and some babies may still get RSV infection despite their mothers having the vaccine. However, for most babies born to vaccinated mums, any RSV infection should be less severe.

When you will be offered the RSV vaccine

You should be offered it around the time of your 28 week antenatal appointment. If you haven’t heard by this stage, contact your maternity service or GP practice to make an appointment. Having the vaccine in week 28 or within a few weeks of this will help you build a good level of antibodies to pass on to your baby before birth. This will give your baby the best protection, including if they are born early.

You can still have the vaccine later in your pregnancy but it may be less effective. If it wasn’t possible to have your vaccine earlier, it can be given right up until you have the baby. If you have it very late in pregnancy, it may still protect you from infection and reduce the risk of you spreading infection to your newborn baby.

You will be offered the RSV vaccine during every pregnancy

Having the vaccine during each pregnancy will offer your new baby the best protection from RSV.

The safety of RSV vaccination during pregnancy

The vaccine has been studied in clinical trials of almost 4,000 women and been given to many thousands of women in national programmes. Monitoring in the USA, where it has been given to over 100,000 women, has shown a good safety profile. In the main clinical trial, in the month after vaccination, there were slightly more premature babies in the vaccine group (2.1%) than the group that didn’t have the vaccine (1.9%). This difference is most likely to be due to chance.

The vaccine has been approved by medicines regulators in the UK, Europe and USA on the basis of protection, quality and safety.

Babies at a higher risk of RSV infection

Some babies are at higher risk of RSV, such as those who are very premature, those with severe heart disease or those with weakened immunity. They may also be offered an antibody injection. This injection will provide additional protection on top of any antibodies they might get from their mother.

Having the RSV vaccine at the same time as other vaccines

It is important to have your vaccines at the right time in pregnancy

Whooping cough (pertussis) vaccine

The whooping cough vaccine is usually given earlier in pregnancy. Around the time of the mid pregnancy scan, usually 20 weeks.

Flu vaccine

Flu vaccine can be given at any stage of pregnancy. You should have it as soon as it becomes available to you.

When you are called up for your RSV vaccine, if you have not yet had your whooping cough or flu vaccines, then you should have them at the same time.

Side effects from the RSV vaccine

The vaccine is a single injection in your upper arm. Side effects are usually mild. These may include:

• headache
• muscle ache
• soreness, redness or swelling at the site of the injection

You can report suspected side effects to the Medicines and Healthcare products Regulatory Agency (MHRA):

• on the Yellow Card website
• by calling the free phone line: 0800 731 6789 (9am to 5pm, Monday to Friday)
• by downloading the Yellow Card App on iOS or Android

Further information

Speak to your midwife or GP practice for more information on the RSV vaccine and other vaccines you will be offered during your pregnancy.

Read the patient information leaflet for the RSV vaccine Abrysvo.

Read about the vaccines you should be offered during your pregnancy.

Read further information on vaccinations you will be offered when pregnant.

Read information about the RSV vaccination programme for older adults.