Respiratory syncytial virus (RSV) is a leading cause of bronchiolitis, bronchitis, and pneumonia in young children, especially premature infants. The World Health Organization (WHO) reports that over 3.6 million children are hospitalized due to RSV annually, with more than 100,000 fatalities. Approximately 50% of these deaths occur in infants under six months old.

In Vietnam, the virus circulates year-round, typically peaking during seasonal transitions, the rainy season, or colder months. RSV primarily spreads through respiratory droplets when an infected person talks, coughs, or sneezes, or through direct contact. Currently, there is no specific treatment for RSV; care focuses on supportive measures and symptom relief to aid the body's recovery. The disease often progresses rapidly in young children, easily becoming severe and unpredictable.

Premature infants have underdeveloped respiratory and immune systems, making them more susceptible to severe respiratory distress from RSV compared to full-term babies, requiring longer recovery times. The risk of hospitalization and severe progression is particularly high in very premature infants (born before 32 weeks of gestation) and extremely premature infants (born before 28 weeks).

RSV can lead to acute respiratory failure, collapsed lung, pneumothorax, and bacterial superinfection in premature infants. The disease can also leave long-term sequelae, such as pulmonary fibrosis, impaired respiratory function, recurrent wheezing, or chronic asthma.

Premature baby receiving RSV monoclonal antibody injection at Tam Anh General Hospital. Illustration: Huyen Vu

Given the dangerous nature of the disease, all premature infants who meet health criteria should receive RSV monoclonal antibody injections before hospital discharge, as prescribed by a doctor. If the injection was not administered before discharge, parents can still bring their baby for supplementary administration. Therefore, it is advisable to get your baby vaccinated as soon as possible.

Monoclonal antibodies are indicated for infants from one day old up to under 24 months old. This provides passive immunity for about one peak RSV season, typically six months, helping to reduce the risk of severe illness and hospitalization in infants and young children. For healthy full-term infants, the timing of the injection depends on the local peak RSV circulation: the southern region from may to november, and the northern region from august to april of the following year. It also considers the mother's vaccination history and the child's risk level.

Before the injection, a specialist doctor will examine the child to assess their health status, weight, allergy history, and underlying medical conditions. This assessment determines the appropriate antibody type and dosage. If the child has a high fever, an acute illness, or an unstable chronic condition, the injection may be postponed until their health stabilizes.

After the antibody injection, the child will be monitored for acute reactions for at least 30 minutes. Upon returning home, parents should continue to closely monitor the child's health for the next 24-48 hours. Factors to observe include: breathing rate, body temperature, general skin manifestations, and the skin around the injection site.

Parents should not apply leaves, oils, patches, alcohol rubs, or hot compresses to the child's injection site, as these can easily cause infection. Keep the injection area clean and dry. If the injection site appears swollen or red, parents can gently apply a cool compress around it with a clean cloth. If the child shows any unusual signs, parents should take them to the hospital immediately.

Dr. Nguyen Thi Kim Hoc, Specialist Doctor Level I

Neonatal Center

Tam Anh General Hospital, Ho Chi Minh City