image: RSV is a common contagious virus that infects the human respiratory tract. Here: scanning electron micrograph of human respiratory syncytial virus (RSV) virions (colorized blue) that are labeled with anti-RSV F protein/gold antibodies (colorized yellow) shedding from the surface of human lung epithelial A549 cells.
Credit: NIAID
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
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”, states ECDC senior expert Bruno Ciancio. “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. [1]
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.
‘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’, Ciancio adds.
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.
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Notes to editors
[1] Del Riccio M, Spreeuwenberg P, Osei-Yeboah R, Johannesen CK, Fernandez LV, Teirlinck AC, et al. Burden of Respiratory Syncytial Virus in the European Union: estimation of RSV-associated hospitalizations in children under 5 years. J Infect Dis. 2023 Nov 28;228(11):1528-38. Available at: https://www.ncbi.nlm.nih.gov/pubmed/37246724
[2] There are two RSV immunisation products that have been authorised in the EU over the last three years to provide protection to infants from severe RSV disease. One long-acting monoclonal antibody product administered directly to neonates and infants (Beyfortus) and one maternal vaccine to provide protection to infants through transplacental transfer of RSV neutralising antibodies (Abrysvov).
Based on clinical trials and post authorisation data, the long-acting monoclonal antibodies show strong protection against severe disease and RSV-associated hospitalisation in infants, with similar efficacy and effectiveness estimates ranging between 76% and 86%. See https://www.ecdc.europa.eu/en/publications-data/living-systematic-review-and-meta-analysis-efficacy-and-safety-respiratory