1027: RSV Season Update: Data Gaps, Trends, and Immunization Efforts

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Wednesday, November 12, 2025 with news from the Association of State and Territorial Health Officials. I'm John Sheehan.

Today we'll be talking about RSV, respiratory syncytial virus, with Dr. Susan Kansagra, ASTHO's chief medical officer.

SUSAN KANSAGRA: 

Especially this time of year, we expect cases and RSV activity in general to increase, but, you know, it's a really interesting time actually, right now for the season, because we're currently in a federal shutdown. And that means that some of the dashboards that we've typically had available on the CDC website to show us where we are nationally in terms of activity for RSV, flu, COVID, other respiratory diseases, is not actually available. But that being said, there are other data sources, including state dashboards, that we are looking at. There's also wastewater data and data from healthcare systems that show us that RSV activity is indeed going up. We're starting to see it creep up. It's still pretty low right now, but this is the time of the year where we would expect it to increase and, particularly for the southeast region of the U.S., we are seeing that increase start now, which indicates we'll likely see that in other parts of the country soon as well.

SHEEHAN: 

Public health officials have a variety of tools to combat RSV, things like the Vaccines for Children program.

KANSAGRA: 

We've seen a lot of successes as far as public health tools to- and healthcare tools to prevent RSV. So, one of the things that we know about RSV is that it is a leading cause of hospitalization for infants and has, historically, you know, something that you can't really distinguish from a cold or, you know, typically, any other types of illness around this time of year. But for infants, and particularly premature infants or others that might have chronic conditions, it can lead to severe disease, difficulty breathing, that leads to hospitalizations, ED visits, and so forth. So, we have new tools available to us in the last several years, and that includes both maternal RSV vaccine and it includes RSV monoclonal antibodies. So, those two things have created more protection for infants who are entering their first RSV season, in particular through the VFC program, which is of course, the Vaccines for Children program. Immunization programs across the country have worked to make sure that birthing hospitals are enrolled in the program so that they can provide monoclonal antibodies to babies being born in their hospitals from the get-go. So, there's been a lot of work and lots of partnerships between, again, public health and healthcare institutions to make sure monoclonal antibodies are available. You know, some of the ways that that has happened, again, we know for, you know, the VFC program, hospitals have to enroll. And of course, when you provide any type of medical service, clinical service that requires protocols within the hospital, it requires providers to educate parents and caregivers. It requires upgrades to how they document that information in the EHR. So, a lot of that work has happened over the course of the last two years between public health departments and birthing hospitals working together to ensure that RSV is available and accessible to infants that are being born in those institutions. So, lots of great progress there.

SHEEHAN: 

And because RSV does not recognize state boundaries, partnerships across state lines are essential.

KANSAGRA: 

So, you know, again, we know, based on the data, that RSV monoclonal antibodies are really, really effective in preventing hospitalizations. Some of the data from studies show, you know, anywhere from 40% effectiveness to even higher effectiveness rates, particularly in very young infants. And so, public health departments have partnered with hospitals and healthcare institutions and provider organizations to help ensure that monoclonal antibodies are available. We've seen, you know, really creative partnerships with healthcare institutions to think about how they enroll in the program, how they work with providers to ensure that there's protocols that are in place to make sure every infant is being screened for eligibility for monoclonal antibodies, and then, of course, working on documentation, tracking, supply chain, all those other things you need to consider to make something like this available on the ground in hospitals. So, lots of partnerships and lots of work by immunization programs across the country in collaboration with providers to make it accessible. You know, one of the ways that we are seeing that success by immunization programs is that we have seen the number of hospitals enrolled in the VFC program increase from 292 to over a 1,000 birthing hospitals specifically enrolled, which has enabled VFC monoclonal antibody to be provided through this program in these institutions. So, that is great progress. That's, you know, over a tripling of that number. And certainly there's more work to do to enroll more hospitals, but that is one, you know, measure of success, and that we are seeing more institutions enrolled in the program, and that enables them to provide VFC monoclonal antibodies to those families. So, that's great news there as well. And then, you know, overall, again, one of the things that we've seen this past season, this past year, where we had both things, both maternal vaccine as well as monoclonal antibodies, is we've seen a lower RSV hospitalization rate for infants than we have in the past. So, that's a sign that, you know, ideally, points to the fact that we are seeing more accessibility. We are seeing more uptake of these things. We are seeing more impact. It's keeping kids out of the hospital at the very youngest age, and an opportunity to further build on those successes.

SHEEHAN: 

Dr. Susan Kansagra is ASTHO's chief medical officer. If you want to learn more, visit A, S, T, H, O, (ASTHO) .org or check out our show notes.

The Association of State and Territorial Health Officials and the Alzheimer's Association published a new report introducing the strategic plan alignment tool to help public health agencies better integrate plans across state health, aging, and dementia. Read about this structured framework to see how your jurisdiction can simplify complex planning and boost collective impact by clicking the link in the show notes.

I'm John Sheehan, and this has been Public Health Review Morning Edition from the Association of State and Territorial Health Officials.