RSV Vaccination for Pregnant People

CDC recommends two ways to protect babies from getting very sick with Respiratory Syncytial Virus (RSV):

  • An RSV vaccination given during pregnancy
    Pfizer’s bivalent RSVpreF vaccine (Abrysvo) is recommended for use during pregnancy (maternal RSV vaccine). It is given during RSV season to people who are 32 through 36 weeks pregnant. Or,

Babies born to mothers who get RSV vaccine at least 2 weeks before delivery will have protection and, in most cases, should not need an RSV immunization later.

When is RSV season?

In most regions of the United States RSV season starts in the fall and peaks in the winter, but the timing and severity of RSV season can vary from place to place and year to year. RSV season is likely to be different for people living in Alaska, parts of Florida, Hawaii, Puerto Rico, US Virgin Islands, Guam, and the U.S.-affiliated Pacific Islands.

The goal of maternal RSV vaccination is to protect babies from getting very sick with RSV during their first RSV season. In most of the continental United States, this means maternal RSV vaccine will be given in September through January.

If you live in Alaska, Florida, or outside the continental U.S., talk to your healthcare provider about when RSV season is expected where you live, so that your infant can be protected against RSV disease.

Who should get the maternal RSV vaccine?

People who are 32 through 36 weeks pregnant during September through January should get one dose of maternal RSV vaccine to protect their babies. RSV season can vary around the country. If you live in Alaska, Florida, or outside the continental U.S., talk to your healthcare provider about when RSV season is expected where you live.

How is the maternal RSV vaccine administered?

Maternal RSV vaccine is given as a shot into the mother’s upper arm. Only a single dose (one shot) of maternal RSV vaccine is recommended. It is not yet known whether another dose might be needed in later pregnancies.

How well does the maternal RSV vaccine work?

When someone gets RSV vaccine, their body responds by making a protein that protects against the virus that causes RSV. The process takes about 2 weeks. When a pregnant person gets RSV vaccine, their protective proteins (called antibodies) also pass to their baby. So, babies who are born at least 2 weeks after their mother gets RSV vaccine are protected at birth, when infants are at the highest risk of severe RSV disease. The vaccine can reduce a baby’s risk of being hospitalized from RSV by 57% in the first six months after birth.

What are the possible side effects of the maternal RSV vaccine?

In the clinical trials, the side effects most often reported by pregnant people who received the maternal RSV vaccine were pain at the injection site, headache, muscle pain, and nausea.

Although not common, a dangerous high blood pressure condition called pre-eclampsia occurred in 1.8% of pregnant people who received the maternal RSV vaccine compared to 1.4% of pregnant people who received a placebo.

The clinical trials identified a small increase in the number of preterm births in vaccinated pregnant people. It is not clear if this is a true safety problem related to RSV vaccine or if this occurred for reasons unrelated to vaccination.

To reduce the potential risk of preterm birth and complications from RSV disease, FDA approved the maternal RSV vaccine for use during weeks 32 through 36 of pregnancy while additional studies are conducted.

FDA is requiring the manufacturer to do additional studies that will look more closely at the potential risk of preterm births and pregnancy-related high blood pressure issues in mothers, including pre-eclampsia.

Severe allergic reactions to vaccines are rare but can happen after any vaccine and can be life-threatening. If you see signs of a severe allergic reaction after vaccination (hives, swelling of the face and throat, difficulty breathing, a fast heartbeat, dizziness, or weakness), seek immediate medical care by calling 911.  As with any medicine or vaccine there is a very remote chance of the vaccine causing other serious injury or death after vaccination.

Adverse events following vaccination should be reported to the Vaccine Adverse Event Reporting System (VAERS), even if it’s not clear that the vaccine caused the adverse event. You or your doctor can report an adverse event to CDC and FDA through VAERS. If you need further assistance reporting to VAERS, please email info@VAERS.org or call 1-800-822-7967.

If you have any questions about side effects from the maternal RSV vaccine, talk with your healthcare provider.

Do I need a prescription for a maternal RSV vaccine?

Depending on where you live and where you go to get the vaccine, you might need a prescription. See CDC’s Where to Find Vaccines for information on prescriptions for vaccines.

How do I pay for the maternal RSV vaccine?

Private health insurance

Most private health insurance plans cover the maternal RSV vaccine, but there may be a cost to you depending on your plan. Contact your insurer to find out.

Medicaid

Beginning October 1, 2023, most people with coverage from Medicaid and Children’s Health Insurance Program (CHIP) will be guaranteed coverage of all vaccines recommended by the Advisory Committee on Immunization Practice at no cost to them.

Vaccines for Children (VFC) program

The maternal RSV vaccine will be covered by VFC, a federally funded program that provides vaccines to children who otherwise might not be vaccinated because of inability to pay. Pregnant teens enrolled in Medicaid will not be charged for the vaccine or administration. VFC-eligible teens not enrolled in Medicaid will get the vaccine at no charge but may be charged an administration fee. Children younger than 19 years of age are eligible for the VFC Program if they belong to one or more of the following groups:

  • Medicaid-eligible
  • Uninsured
  • Underinsured
  • American Indian or Alaska Native