Protecting infants against respiratory syncytial virus this winter — ECDC issues advice

As several European countries are currently detecting respiratory syncytial virus (RSV) infections, ECDC issues rapid scientific advice for policymakers and public health authorities on ways to mitigate the impact of RSV disease among infants through immunisation and to support intensified efforts to protect them from RSV across the region. 

In the coming weeks and winter months, especially infants younger than six months of age are at high risk of severe illnesses from respiratory diseases. One of the most common viruses affecting this group is RSV. Severe RSV infection can lead to serious complications requiring hospitalisation or admission to intensive care units. These complications include inflammation of the small airways in the lung (bronchiolitis), pneumonia or bloodstream infection (sepsis).

Prevention starts with better awareness

ECDC senior expert Bruno Ciancio states:

‘Respiratory syncytial virus can cause a very severe illness in infants, even in those who are healthy, having a significant impact on their families and healthcare systems. It is imperative that healthcare workers are aware of RSV epidemiology in their community and follow national guidelines for the prevention of RSV in their patients'.

On average, an estimated 250 000 children under the age of five are hospitalised each year across Europe due to RSV infection, with every third child hospitalised during their first months of life.

Available surveillance data for the EU and EEA show that every second person who tested positive for RSV during the winter season 2024/25 was a young child aged 0–4 years. Twelve per cent of those children were admitted to intensive care units, and one child died.

Safe and effective immunisation options available in Europe

Since 2022, the EU has authorised safe and effective immunisation products to prevent RSV disease in infants. These include long-acting monoclonal antibodies given to newborns and infants during their first winter season and maternal vaccines for pregnant people to protect infants during their first months of life. Ciancio adds:

‘Severe cases of RSV in infants can be prevented by vaccinating pregnant individuals or by immunising infants after birth. Premature babies and those with chronic lung conditions are particularly vulnerable to severe illness and can be prioritised for immunisation when universal immunisation is not possible’.

Twenty-three countries across the EU/EEA already recommend RSV immunisation with long-acting monoclonal antibodies and 19 of these have funded programmes in place, either for all babies born during the winter season (universal immunisation) or for infants at high risk of severe illness. Three EU/EEA countries (Poland, Romania, Slovenia) use maternal vaccination exclusively and five countries (Belgium, Cyprus, France, Greece, Luxembourg) offer it as an alternative for protection alongside long-acting monoclonal antibodies. 

To support EU/EEA countries, ECDC will continue to generate and assess evidence on RSV immunisation effectiveness and impact, as well as strengthen surveillance and immunisation programmes in the EU.