RSV Frequently Asked Questions (FAQs)
This webpage is designed to help providers and local health department staff stay abreast on the latest information on RSV immunizations.
What is RSV?
Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes colds, but may cause severe disease in infants and older adults. In the United States, RSV usually starts in the fall season and peaks in the winter.
RSV is the leading cause of hospitalization and the most common cause of bronchiolitis and pneumonia in children younger than 1 year of age in the United States. Almost all children get RSV at least once before they are two years of age. CDPH recommends that all infants born October-March receive RSV immunization within the first week of life, ideally during their birth hospitalization to ensure early protection. To support this, birthing hospitals are encouraged to enroll in the Vaccines for Children (VFC) program so that all newborns, regardless of insurance status, have access to RSV immunization before discharge.
In adults, the risk of severe RSV illness also increases with age. Infections are especially dangerous for older adults or those with underlying medical conditions. Each year an estimated 60,000-160,000 older adults are hospitalized and up to 10,000 die due to RSV.
Jump to RSV immunization information for:
Beyfortus (nirsevimab) and Enflonsia (clesrovimab): RSV Immunization (Monoclonal Antibody) for Infants
- Are RSV immunizations available through the Vaccines for Children (VFC) Program?
Yes. Beyfortus (nirsevimab)and Clesrovimab (Enflonsia) are available through the VFC Program. More information is available on the Nirsevimab and Clesrovimab clinical VFC letters.
- Are VFC providers required to offer RSV immunizations?
Yes. VFC providers are required to offer nirsevimab or clesrovimab if they see patients in that age group, along with all other age-appropriate ACIP-recommended vaccines. See VFC’s provider requirements for more details.
- Which staff members may administer RSV immunizations?
Staff members that may administer RSV immunizations include physicians, physician assistants, nurses, medical assistants, pharmacists and pharmacy interns, assuming that they meet their usual conditions for immunizing.
- Am I able to record doses of Beyfortus (nirsevimab) and Enflonsia (clesrovimab) for infants in CAIR now?
Yes! Beyfortus (nirsevimab) is in CAIR under the brand name “Beyfortus” and Enflonsia (clesrovimab) is in CAIR under the brand name “Enflonsia.”
- Am I required to record RSV immunization doses for infants in CAIR?
Yes, it is a requirement. Per California law, please ensure all immunizations administered are entered into a California Immunization Registry (CAIR or RIDE).
- Is there a list of birthing hospitals that are currently offering RSV immunization to newborns?
Yes! CDPH recognizes birthing hospitals enrolled in VFC and administering RSV immunizations to VFC-eligible newborns. If your birthing hospital is not listed, please ask their leadership to reach out to the VFC Team at VFCEnrollment@cdph.ca.gov for enrollment assistance.
- What should I do with unused doses of RSV immunization?
RSV immunizations have a lengthy shelf life and are expensive. Save unused doses for the following RSV season and consider labeling as “Keep for Fall.” Unused and unexpired doses of VFC RSV immunizations cannot be returned to McKesson. Privately purchased doses of ABRYSVO may continue to be used year-round to protect patients 50 years and older (while VFC supplies are indicated for pregnant adolescents).
- How can a provider evaluating a baby for RSV immunization determine if the baby’s birthing parent received prenatal RSV vaccine?
If prenatal records are unavailable to determine if the baby’s birthing parent was immunized during pregnancy, the birthing parent may request an immunization history report from their prenatal care provider or access their Digital Vaccine Record at MyDVR.cdph.ca.gov. The immunizing provider may also check the California Immunization Registry (CAIR) to confirm receipt of prenatal RSV vaccine at least 14 days before delivery or postnatal RSV immunization at the birth hospital or clinic.
RSV Vaccine for Pregnant People
- Is the prenatal RSV vaccine covered by Medi-Cal and private insurance?
Yes. AB144 requires health insurance plans regulated (including Medi-Cal and private insurance plans) in California to cover immunizations recommended by the California Department of Public Health. Medi-Cal offers immunizations as a medical and pharmacy benefit. Prenatal care providers who do not stock prenatal immunizations should provide strong referrals to patients’ in-network pharmacies. Individuals, or their healthcare providers, should contact the health insurance plan to see where to get vaccinated to ensure coverage. -
How should prenatal RSV vaccination be documented?
It is critically important to document receipt of maternal RSV vaccine as most infants of vaccinated mothers are not recommended to receive nirsevimab. Documentation should occur in the:• Immunization Information System (CAIR or Healthy Futures)
• Electronic Health Records (EHRs)
• Written documentation for patient to bring to birthing hospital and pediatric provider visits.
RSV Vaccines (Abrysvo, Arexvy, and mRESVIA) for Adults
- Is RSV vaccine available through the Vaccines for Adults (VFA) Program for uninsured or underinsured adults?
Yes, however available quantities are limited. Please check with VFA for updates. You can contact the VFA program at my317vaccines@cdph.ca.gov.
Resources:
- RSV Immunization Guide to Prevent Severe RSV in Infants and Toddlers (PDF)
- California Respiratory Virus Dashboard
- RSV Immunization Information
- RSV Communications Toolkit
- Public Health for All: Evidence-based Recommendations
- RSV Immunization Frequently Asked Questions (AAP)
- Maternal RSV Vaccination (ACOG)
- Maternal RSV Vaccination Practice Advisory (ACOG)
- Adult Immunization Schedule (AAFP)