More young children with underlying health conditions now qualify for RSV immunization ahead of the 2026-2027 respiratory season.
The American Academy of Pediatrics broadened its eligibility criteria in an updated policy statement published September 2, 2026, in Pediatrics.
The change targets toddlers aged 8 through 19 months who face a higher risk of severe illness during a second RSV season.
Respiratory syncytial virus is one of the leading reasons infants and toddlers end up in the hospital.
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Before the arrival of the newer immunization products, CDC estimates put annual RSV hospitalizations at 58,000 to 80,000 among children younger than 5 in the United States.
Who is now on the expanded list
The AAP's newly widened high-risk categories for a second RSV season include children born preterm, and those with hemodynamically significant congenital heart disease.
Also included are children with anatomic pulmonary abnormalities or neuromuscular disorders, and children with Down syndrome or other chromosomal differences.
Only children aged 8 through 19 months who meet these criteria are eligible for immunization in that second season.
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Infants younger than 8 months entering their first RSV season should still receive a single dose unless they are already protected by maternal RSV vaccination during pregnancy.
What the RSV shot actually is
Two long-acting monoclonal antibodies dominate the current guidance.
Nirsevimab (Beyfortus) and clesrovimab (Enflonsia) are given as a single injection during RSV season and provide passive protection rather than triggering the child's own immune system as a traditional vaccine would.
Nirsevimab is the product approved for children entering a second RSV season.
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Clesrovimab is approved only for the first season, though the FDA is reviewing a second-season indication.
The AAP no longer recommends palivizumab, the older monthly injection that had been used for high-risk infants for years.
Real-world data from the first full seasons of nirsevimab use have shown steep drops in RSV hospitalizations among protected infants, one of the reasons the academy pushed to formalize wider access.
COVID-19 guidance for children also updated
Alongside the RSV update, the AAP issued revised COVID-19 vaccine recommendations for the 2026-2027 season.
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All infants and children ages 6 through 23 months without contraindications should receive a COVID-19 vaccine.
Children ages 2 through 18 at increased risk of severe COVID-19 should receive a single dose of an age-appropriate vaccine, regardless of prior vaccination status.
What to ask at your child's next visit
Parents of a young child, a former preterm baby, or a child with a heart, lung, neuromuscular or chromosomal condition should ask their pediatrician at the next well-child visit whether their child now qualifies for an RSV shot, and which product is appropriate.
In most parts of the country, RSV activity begins climbing in the fall and peaks during the winter months, so timing the immunization before the local season starts offers the fullest protection.
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This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.