RSV Prevention in Babies: Who’s Eligible for Beyfortus and How to Access It

Almost all children are exposed to respiratory syncytial virus (RSV) by the age of 2. But this cold-like virus can be particularly dangerous in babies and older adults. Recently, the FDA has approved multiple tools to prevent RSV — including Beyfortus (nirsevimab-alip). 

Beyfortus is a lab-made antibody treatment that can prevent babies and certain young children from getting seriously ill from RSV. It has antibodies that can fight off the virus before it causes serious complications, such as pneumonia.

So, which children are eligible for Beyfortus, when should they get it, and where can you find it? We answer these questions and more below.

What is RSV?

RSV stands for respiratory syncytial virus. It commonly spreads in the fall and winter. For most people, RSV causes cold-like symptoms. But RSV can cause more serious lower respiratory tract infections in infants and older adults, which can sometimes lead to hospitalization.

Symptoms tend to show up within 4 to 6 days of being infected. Common symptoms of RSV include:

• Coughing

• Pauses in breathing

• Fever

• Runny nose

• Sneezing

• Poor appetite

• Wheezing

• Irritability

An RSV infection usually gets better within 1 to 2 weeks. But in more severe cases, it can cause pneumonia or bronchiolitis (inflammation of the small airways of the lungs).

Why are babies at risk for severe RSV?

RSV is the most common cause of hospitalization of babies in the U.S. The biggest reasons babies are at a higher risk for RSV than adults are that their immune system isn’t fully developed yet and they haven’t been exposed to RSV before. So they’re more vulnerable to infections. They also have smaller airways than older children and adults. That means even a small amount of inflammation can lead to severe symptoms.

The younger the baby, the more at risk they are of being hospitalized. Every year, about 2% to 3% of babies under 6 months old who get RSV are hospitalized. Premature infants and children with certain heart or lung conditions or weakened immune systems are at greater risk for severe illness from RSV.

EXPERT PICKS: WHAT TO READ NEXT

• About RSV: Respiratory syncytial virus (RSV) usually causes mild cold symptoms. But babies and older adults are more likely to develop severe illness. Here’s everything you need to know about RSV.

• Can RSV turn into pneumonia? Learn more about who’s at risk for pneumonia from RSV, symptoms to look for, and ways to stop it from happening.

• RSV vaccines: Get up to speed on the state of RSV vaccines, including what’s available and what’s being studied.

What is Beyfortus?

Beyfortus is an immunization that works differently from a traditional vaccine, which stimulates the immune system to make antibodies. Instead, Beyfortus provides RSV-fighting antibodies directly to your child, offering protection right away.

A trained healthcare professional injects Beyfortus into the muscle. If your child is receiving Beyfortus before or during their first RSV season, they’ll get one injection. The dose depends on their body weight — they’ll receive either 50 mg or 100 mg. 

Children receiving Beyfortus for their second RSV season will get two injections at 100 mg each. They’ll get these injections back to back in two different injection sites.

It’s still possible to get RSV after receiving Beyfortus. Research showed that Beyfortus was about 80% effective at reducing the risk of RSV cases severe enough to require a healthcare visit, including hospitalization. It was also 90% effective at preventing intensive care unit admissions.

Who is eligible for Beyfortus?

Beyfortus is FDA approved for babies born during (or entering) their first RSV season. It’s typically administered from October through the end of March. Beyfortus is also approved for children up to 24 months old who are vulnerable to severe RSV through their second season. 

The CDC doesn’t have recommendations for children who are older than 19 months. Still, your child’s pediatrician may determine that your child could benefit from Beyfortus, even if they’re older than 19 months.

Children under 8 months

There may be rare exceptions, but Beyfortus isn’t usually necessary if the mother received an RSV vaccine (Abrysvo) during pregnancy and the baby was born more than 14 days after the dose. This is because RSV antibodies pass from the mother to the fetus, which protects the baby after birth for 6 months.

Otherwise, the CDC recommends that all babies younger than 8 months old who are born just before or during their first RSV season receive Beyfortus if:

• It’s not known if the RSV vaccine was given during pregnancy.

• The baby was born less than 14 days after an RSV vaccine was given during pregnancy.

In these situations, it’s recommended that babies receive Beyfortus within a week after being born (and ideally during the birth hospitalization, if born in a hospital).

Children 8 months through 19 months

It’s also recommended that certain children ages 8 to 19 months old get Beyfortus if they’re at increased risk for severe RSV and entering their second season. These include:

• Children with severely weakened immune systems

• Certain children with chronic lung disease of prematurity, also known as bronchopulmonary dysplasia 

• Certain children with cystic fibrosis 

• American Indian or Alaska Native children

For these children, it doesn’t matter if the mother got an RSV vaccine during pregnancy.

Follow up with your child’s pediatrician to find out if they would benefit from receiving Beyfortus.

When is the best time to get Beyfortus?

Timing is important for Beyfortus to work the best for your child. A dose should provide protection for at least 5 months — the length of a typical RSV season. So Beyfortus should be given shortly before or during the RSV season (usually October through March).

In general, Beyfortus timing can depend on when your child was born:

• Birth between October and March: Receive Beyfortus within 1 week of birth

• Birth between April and September: Receive Beyfortus in October or November of that year 

If your child received Beyfortus for their first RSV season, their pediatrician may recommend another dose for their second RSV season. It’s ideal for your child to receive it in October or November. This helps ensure that Beyfortus offers protection for the majority, if not all, of the RSV season. However, they can still get their dose through the end of March if they haven’t already gotten it during that RSV season.

Most children only get one dose of Beyfortus per RSV season. But children undergoing heart surgery with cardiopulmonary bypass should get an additional dose afterwards. If your child has a planned heart surgery, talk to your child’s pediatrician about when they should get Beyfortus.

Depending on when your child was born, their Beyfortus dose might line up with their 2-, 4-, or 6-month well child visit. They can receive Beyfortus at the same time as routine childhood vaccines normally given during these visits. 

Where can you get Beyfortus?

After Beyfortus was approved last year, it was difficult to find due to high demand. But it should be more available during the 2024-2025 RSV season. 

Your child may be able to receive Beyfortus at a hospital, county health department, or your pediatrician’s office. Contact your child’s pediatrician to find out where they can receive Beyfortus in your area.

Does insurance cover Beyfortus?

The Affordable Care Act requires most private health insurance plans to cover Beyfortus. This is because it’s recommended by the CDC’s Advisory Committee on Immunization Practices. 

For Medicaid-eligible children, the Vaccines for Children (VFC) program covers Beyfortus for free. Children who are uninsured or underinsured, American Indian, or Alaskan Native are also eligible for free immunizations through VFC. You can use this directory to find state and local immunization websites for locating a vaccine provider near you.

Keep in mind that your health plan may require your child to get Beyfortus from certain healthcare professionals in order for them to pay for it. It’s best to call your health plan directly to check if Beyfortus is covered.

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Written by:

Kristianne Hannemann, PharmD

Kristianne Hannemann, PharmD, is a licensed pharmacist in California. She has been a retail pharmacy manager and staff pharmacist for over 7 years and has contributed drug information content to different health companies.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

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