Few things are more frightening for a parent than watching a baby struggle to breathe. A child who seemed well suddenly has difficulty feeding, becomes exhausted or needs hospital care. For families, respiratory syncytial virus, or RSV, can mean anxious hours in an emergency department and days at a hospital bedside.
RSV is common, but it is not simply another cold for infants. It can cause bronchiolitis, pneumonia, difficulty feeding and respiratory distress. The burden also is felt across our health-care system. RSV contributes to 5,831 pediatric hospitalizations and an estimated $66 million in health-care costs each year in Canada. Healthy, full-term infants under six months account for the majority of severe RSV disease, related hospitalizations and intensive care admissions, meaning we cannot reliably predict which baby will become seriously ill.
Too many expectant parents still know little about RSV. Many first hear about it only after someone they know has a sick baby or their own child develops symptoms. By then, the conversation has shifted from how to help protect a baby to how to care for a baby who is already ill. There is no specific treatment that cures RSV itself.
For years, there was little we could do beyond supportive care. Today, however, that has changed.
Families now have two evidence-based strategies to discuss with a health-care provider. Immunization during pregnancy allows protective antibodies to pass to the baby; a long-acting monoclonal antibody can be given directly to the infant after birth. Both approaches have been well studied and shown to be safe and effective ways to help protect babies from severe RSV disease.
Recent Canadian research reinforces why broad protection matters. During the 2024-25 RSV season, a study at seven pediatric hospitals in Ontario and Quebec found that only three per cent of infants who tested positive for RSV had a comorbidity. Serious RSV illness is not confined to babies who can be identified in advance as high risk. Every family should have an opportunity to discuss protection before a baby becomes sick.
The protection options have changed, and clinical guidance has changed with them. Maternal RSV immunization may now begin at 28 weeks and continue through 36 weeks plus six days. The broader window creates more opportunities to discuss and offer protection, including coadministration with other recommended immunizations during pregnancy.
That conversation cannot end with a general recommendation. Access pathways for RSV protection are inconsistent across Canada. One province may fund an option that another does not. Eligibility rules can differ, as can who is authorized to prescribe protection and where it can be administered. Product availability may also vary. For families, these differences can turn a time-sensitive health decision into a confusing search for answers.
In medicine, a recommendation is only useful if a patient can follow through. Health-care professionals are much better positioned to support families when they understand not only the evidence, but also what is funded, who is eligible, where protection is offered and when it should be given. Without practical, current guidance, even a well-informed conversation can end with a patient unsure where to go next.
Families also need time. A discussion about RSV protection should not happen for the first time as a parent is preparing to leave hospital with a newborn. Conversations should begin earlier and continue throughout pregnancy, giving families an opportunity to review credible information, ask questions and consider their options before a decision becomes urgent. Health-care professionals should explore what may stand in the way for each family rather than assuming that a question or delay reflects hesitancy.
Practical implementation guidance can help turn these conversations into action. Health-care professionals need clear, current information that reflects the funding, eligibility and delivery arrangements in their own jurisdiction. The FMWC Infant RSV Protection Collective’s implementation brief outlines recommendations to support this work.
Families, health-care professionals and policymakers each have a role. Families should ask about RSV protection during pregnancy and before delivery. Health-care professionals should make RSV a routine part of prenatal and infant care, use the latest guidance and provide clear next steps. Governments, public health agencies and professional bodies should ensure providers have the practical information they need to guide patients through local access.
Canada now has more opportunities to help protect babies from severe RSV disease than it did only a few years ago. We should not lose them because a family heard about RSV too late, a health-care professional was working from outdated guidance or the next step was unclear.
RSV season is here. If we act now to raise awareness, support informed conversations and make access easier to navigate, more families can consider protection before severe illness occurs.
