HMN 2026: how to protect babies for longer against RSV

New strategies may be needed to protect infants older than six months against the highly infectious Respiratory Syncytial Virus or RSV, new University of Queensland research has found. The study examined 18,683 cases of RSV among Queensland children under 2 years of age between 2022 and 2023, finding particularly high rates of the virus in children aged 0–15 months. The findings are published in the journal BMC Public Health.

Dr. Lisa McHugh, from UQ’s School of Public Health said protection from RSV immunizations administered to mothers during pregnancy or to infants at birth could provide protection to babies up to about six months, but the study found cases were still very high up until 15 months old.

“Currently pregnant women in their third trimester or babies from birth up until 8 months of age can access RSV immunizations for free,” Dr. McHugh said. “This service is provided in Queensland year-round, but babies currently aren’t eligible for immunization after birth if their mother was vaccinated during pregnancy, unless they are at higher risk of severe disease.

“This means infants will get about six months of protection from either the maternal vaccine or immunization after birth. However, our study shows an urgent need to consider new strategies to protect babies older than six months when protection from maternal or birth-dose immunization declines.”

RSV is a leading cause of hospitalization from bronchiolitis and pneumonia in Australian children under 2 years old.

Using Queensland Notifiable Conditions Systems data, the study found the highest numbers of RSV cases were recorded in zero to 12-month-olds in Queensland, with 10,613 cases reported in this age group. “It is extremely common, causing about 12,000–15,000 hospital admissions annually, costing the country’s health care system up to $121 million per year,” Dr. McHugh said.

The study also examined socioeconomic factors, family size, and remoteness. Ph.D. candidate and lead author Sarah Graham said Queensland children living in larger families or in arid or semi-arid climates experienced a higher burden of RSV in 2022–2023.

“RSV has a greater potential of spreading in larger households, as older siblings often bring the virus home from school or daycare and pass it on to infants,” Graham said. “The higher incidences of RSV infections reported in hotter and drier parts of Queensland could be an anomaly—we don’t know why, and we would need to review RSV data over the next few seasons to see if this pattern continues.”

Graham said Queensland had significant climate zone diversity with coastal areas of high humidity and rainfall, and hot and dry areas towards the state’s interior. The researchers also found a lower incidence of RSV in remote areas, but this could be due to under-testing.

“Rather than a rollout of a one-size-fits-all approach to ensuring adequate RSV immunization coverage for Queenslanders’ infants, we would benefit from strategies that tailor to different climatic and socioeconomic factors,” Graham said.

“Some climate zones see outbreaks earlier or later in the year, so that may mean starting health promotions at different times in different regions. We would like to research this area further and also dive deeper into the drivers of severe RSV cases that cause hospitalization and ICU admissions.”

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