From Beach Weather to RSV: Welcome to Chicago.

Well, I broke down and finally did it this weekend.

I didn’t want to, but I couldn’t take it anymore.

Maybe you did it to.

I turned on our heat.

Wasn’t it just last Monday that I was talking about going to the beach? Ahhhhh, Chicago. You confuse me so much, yet I continue to love you.

Well, while today’s weather in Chicago may be rebounding, we still have one last seasonal vaccine to talk about.

RSV. Respiratory syncytial virus.

In most people, RSV presents much like the common cold. But in infants, older adults, and people with certain medical conditions, this virus can be much more serious. RSV causes millions of respiratory illness episodes worldwide and is responsible for thousands of deaths each year in the United States.

So, let’s talk about who needs protection and what options are available.

Who Needs RSV Protection?

There are three main groups we need to think about:

1. Infants

2. Pregnant women

3. Adults age 75 and older, as well as certain younger adults at increased risk

Let’s break it down.

Infants and RSV

Babies have a lot going on in their first year of life. They’re learning to eat, sleep (sometimes), and hold late-night parties at 3 a.m. Now, do you really want to add boogers and loud screeching to that?

Because infants’ immune systems are still developing, RSV can be a bigger threat during this time.

We now have two ways to protect infants against severe RSV: vaccination for the mom during pregnancy (see below) or giving the baby a preventive antibody injection after birth.

Most babies need only one of these options.

Tiny toes and soft wrinkles capture infancy.

Enter Beyfortus.

Beyfortus is a little different from a traditional vaccine. A vaccine teaches the immune system to recognize a virus and mount a defense. Beyfortus, on the other hand, is a monoclonal antibody that provides ready-made protection. These antibodies offer immediate, temporary protection during the months when infants are particularly vulnerable to severe RSV.

Babies born during RSV season (fall/winter) generally should receive the antibody injection within their first week of life, ideally before leaving the hospital. Babies born outside RSV season can receive it shortly before their first RSV season begins.

Beyfortus is recommended for infants younger than 8 months entering their first RSV season who are not adequately protected by maternal vaccination. Some children ages 8–19 months at increased risk of severe RSV illness may also qualify for protection during their second season.

These higher-risk children include certain children with chronic lung disease, severe immunocompromise, or cystic fibrosis, as well as certain American Indian and Alaska Native children.

Pregnant Women and RSV

The other way to protect babies is to vaccinate their mothers during pregnancy.

The RSV vaccine Abrysvo is recommended for pregnant women between 32 and 36 weeks of pregnancy. Once the mother receives the vaccine, antibodies cross the placenta and help protect the baby against severe RSV during the first months of life.

Clinical trials found that maternal RSV vaccination reduced the risk of severe RSV lower respiratory tract disease in infants by 91.1% during the first 90 days after birth and 76.5% during the first 180 days.

Pretty good, right?

Man, moms really are selfless superheroes. Growing a human being is apparently not enough work. They can also help their babies prepare for respiratory viruses before they’ve even taken their first breath.

The good news is that babies whose mothers received the RSV vaccine during pregnancy generally do not need the antibody injection, although there are some exceptions.

A serene silhouette of a pregnant woman stands against the backdrop of a tranquil sunset, symbolizing peace and anticipation.

Adults and RSV

Now, for those of us who no longer worry about diapers (at least not yet) and instead concentrate on other things, like cholesterol, estrogen, and creaking bones.

There are three RSV vaccines available for adults: Arexvy, Abrysvo, and mResvia. All are acceptable options for eligible adults, and there is currently no preference for one over another.

The good news? RSV vaccination is currently a one-time dose, not an annual vaccine. If you’ve already received an RSV vaccine, you generally do not need another dose at this time.

The CDC recommends RSV vaccination for:

• All adults age 75 and older.

• Adults ages 50–74 who have certain medical conditions or other factors that increase their risk of severe RSV illness.

So, what conditions increase that risk?

• Chronic cardiovascular disease, such as heart failure or coronary artery disease.

• Chronic lung disease, including COPD, emphysema, asthma, or cystic fibrosis.

• Certain forms of diabetes, particularly when complications are present.

• Neurologic or neuromuscular conditions that weaken respiratory muscles or make it difficult to clear secretions.

• Chronic liver disease.

• Certain chronic blood disorders.

• Severe obesity.

• Moderate to severe immune dysfunction.

• Advanced kidney disease or dependence on dialysis.

• Residence in a nursing home or other long-term care facility.

• Other factors, including frailty, that may increase the risk of severe illness.

This is not an exhaustive list, and not everyone with a condition on this list will have the same level of risk. Your healthcare professional can help determine whether vaccination is recommended for you.

And if you’re between 50 and 74 and wondering whether this applies to you, don't assume you're too young to worry about RSV. Unfortunately, our bodies do not always wait until we're emotionally prepared to start acting our age.

The Bottom Line

I know. Another respiratory virus. Another vaccine conversation. Another reminder that our immune systems apparently need a little help keeping up with everything the world throws at them.

But vaccines are one of the tools we have to prevent severe illness, hospitalizations, and deaths. RSV protection is particularly important for babies and older adults, who are more vulnerable to serious complications.

If you’re pregnant, have an infant, or are an older adult, talk with your healthcare professional about which RSV protection option is right for you.

And now, if you’ll excuse me, I’m going to enjoy this brief return to warmer Chicago weather.

I may even open a window.

A serene corner featuring a wooden-framed window with sheer curtains, complemented by earthy ceramic vases on the sill and a cozy chair draped with a textured blanket.

And I’m not turning the heat back on....for now.

After all, this is Chicago. The beach may have been calling last week, but winter is probably just waiting around the corner.

Stay warm, stay healthy, and I’ll see you next time for more midlife musings from your friendly neighborhood family doc.