RX Review: RSV prevention and pediatric hospitalization

Respiratory syncytial virus (RSV) is a leading cause of hospitalization in infants and young children, placing a significant burden on families, hospitals, and the healthcare system. Recent advancements in RSV prevention, including maternal vaccination and long-acting monoclonal antibodies, are beginning to shift the clinical conversation from reactive management to proactive protection. In this HCP Live Network RX Review roundtable, moderator Albert Rizzo, MD, chief medical officer of the American Lung Association, leads a discussion on the evolving RSV landscape, with a focus on what these advances mean for pediatric care.

Rizzo is joined by 2 expert panelists: Tina Tan, MD, a pediatric infectious disease physician and professor of pediatrics at Northwestern University’s Feinberg School of Medicine; and Joanne Nazif, MD, a pediatric hospitalist at Children’s Hospital at Montefiore and associate professor of pediatrics at Albert Einstein College of Medicine.

In this first installment of a 3-part video series, Tan describes the impact of new preventive tools on clinical practice. She notes that both the RSV vaccines and monoclonal antibody nirsevimab have significantly reduced RSV-related hospitalizations and disease severity in infants, especially during the second year following nirsevimab’s introduction. Tan emphasizes the protective effect of maternal vaccination, which has shown promise in shielding newborns from RSV in the early months of life. However, she also points out that uptake among older adults remains low, resulting in continued hospitalizations for severe RSV infections in that population.

Nazif brings a hospitalist’s perspective, highlighting that while preventive options have improved, therapeutic approaches for RSV remain largely unchanged. Supportive care is still the cornerstone of treatment, as various pharmacologic interventions—including bronchodilators and hypertonic saline—have not demonstrated consistent benefits. This makes prevention all the more essential.

The panel also reviews epidemiologic shifts since the COVID-19 pandemic. While RSV hospitalizations declined during the peak pandemic years, recent seasons have seen a return to pre-pandemic trends. Importantly, early data from the 2024–2025 season—marking the first widespread availability of both maternal RSV vaccine and nirsevimab—show a notable decline in infant RSV hospitalizations, particularly in babies under 2 months of age. This is a promising indication of the real-world value of these interventions.

This expert discussion sets the stage for deeper exploration of RSV management and prevention, arming clinicians with timely insights to improve outcomes for pediatric patients.

Our Panelists:

Tina Tan, MD, is a professor of pediatrics at the Feinberg School of Medicine at Northwestern University and an infectious disease physician. She is also medical director of the International Patient and Destination Services Program, president of the Lurie medical dental staff at Ann & Robert H. Lurie Children’s Hospital of Chicago, and president of the Infectious Disease Society of America.

Albert Rizzo, MD, is chief medical officer of the American Lung Association. Board certified in internal medicine, pulmonary, critical care and sleep medicine, Rizzo serves as the moderator for this panel discussion.

Joanne Nazif, MD, is an attending physician in the division of Hospital Medicine at Children's Hospital at Montefiore. She also serves as an associate professor of pediatrics at Albert Einstein College of Medicine.

Rizzo, Tan, and Nazif report no relevant disclosures.