According to new data from the CDC, the US infant mortality rate dropped slightly in 2024 after 2 years of hovering at a late-pandemic plateau. Some experts hypothesized that one reason for the drop could be a vaccination campaign against respiratory syncytial virus (RSV), a common cause of cold-like symptoms that can be dangerous for infants.
Even though the 2024 US infant mortality rate had a small drop, the United States still ranks around 60th compared to other countries. Some countries, such as Japan, Estonia, and Iceland, have infant mortality rates that are 75% lower than the US.
This article will review the respiratory syncytial virus and the RSV vaccine, then discuss the new data from the CDC.
What is respiratory syncytial virus?
The respiratory syncytial virus (RSV) is a common, contagious virus that causes respiratory tract infections. It is a single-stranded RNA virus whose name is derived from large cells known as syncytia, which form when infected cells fuse.
It usually causes mild, cold-like symptoms. However, it can cause serious lung infections, especially in infants, older adults, and people with serious medical problems. For seniors, RSV infections are dangerous as the immune systems weaken.
RSV spreads from person to person through:
- The air, by coughing and sneezing.
- Direct contact, such as kissing the face of a child who has RSV.
- Touching an object or surface with the virus, then touching your mouth, nose, or eyes before washing your hands.
RSV can sometimes lead to pneumonia (infection of the lungs) and congestive heart failure (when the heart can’t pump blood and oxygen to the body’s tissues).
According to the CDC, each year in the United States, RSV leads to approximately—
- 2.1 million outpatient visits among children younger than 5 years old
- 58,000 hospitalizations among children younger than 5 years old
- 177,000 hospitalizations among adults 65 years and older
- 14,000 deaths among adults 65 years and older
I know these numbers pale next to COVID-19, but before the pandemic, an RSV vaccine was often at the top of the wish list for a new vaccine. And for those people who had children or parents who had to deal with a serious RSV case, they probably wish they had access to a vaccine
There are three vaccines currently approved for use in the USA:
- Pfizer’s Abrysvo.
- GSK’s Arexvy.
- Moderna’s mRESVIA.
- Sanofi’s Beyfortus — this is not a traditional vaccine, because it does not activate the immune system, as would occur with infection or vaccination (active immunization). This is a monoclonal antibody that protects against the disease (passive immunization). It is usually given to infants and young children. Protection is likely most effective in the weeks after it is given and wanes over time. It is meant to protect infants when they are most at risk of getting severe RSV disease.
The CDC recommends a single dose of RSV vaccine for all adults aged 75 and older, as well as for those aged 60 to 74 years, who are at increased risk for severe RSV disease. All three of the above vaccines are approved for use in older adults.
The CDC also recommends one dose of the maternal RSV vaccine during weeks 32 through 36 of pregnancy, administered from September through January. Pfizer Abrysvo is the only RSV vaccine recommended during pregnancy.
Research has shown that the RSV vaccines protect against the disease, hospitalization from the disease, and death from RSV.
2024 US infant mortality statistics
The CDC reported on 8 May 2025 that the 12-month-ending US infant (age under one year) mortality rate in 2024 dropped from 5.63 per 1000 live births in 2023 to 5.49 per 1000 in 2024.
The CDC also reported that the neonatal (ages 0-27 days) mortality rate dropped from 3.66 per thousand in 2023 to 3.63 per thousand in 2024.
US infant deaths fell to about 19,900 last year, according to CDC data, compared with about 20,150 in 2023.
The 2022 and 2023 levels were up from 5.44 per 1,000 in 2021 — the first statistically significant jump in the rate in about two decades. Experts attributed those years to a rebound in RSV and flu infections after the two years of COVID pandemic precautions.
Moreover, the CDC began recommending two actions to reduce the burden of RSV on infants. As mentioned above, they began recommending the RSV vaccine for women between 32 and 36 weeks of pregnancy and the monoclonal antibody vaccine for infants.
Although we don’t have published data on the effect of the RSV vaccine on the overall infant mortality rate, Amanda Williams, MD, MPH, interim chief medical officer for the March of Dimes, stated that the RSV vaccine was partly responsible for the drop in the US infant mortality rate.
Coincidentally, the CDC published on 8 May 2025 in MMWR Morbidity and Mortality Weekly Report that infant hospitalizations in the 2024-25 respiratory virus season were more than 40% lower than past averages.
Summary
Although we will need more confirmatory evidence, the two reports from the CDC seem to indicate that the RSV vaccines were responsible for the drop in the US infant mortality rate in 2024.
I know that the infant mortality rate for the United States is way too high compared to other developed (and moderately developed) countries. Although it’s beyond the goals of this article, the high rate can be attributed to many factors — lack of health insurance, racism, poverty, lack of healthcare in economically disadvantaged areas, and so much more. I could write a book about it.
For now, we need to take the wins where we can. And the RSV vaccine is a winner.
Citations
- Patton ME, Moline HL, Whitaker M, Tannis A, Pham H, Toepfer AP, Taylor CA, Goldstein L, Reingold A, Kirley PD, Alden NB, Kawasaki B, Meek J, Kim D, Witt LS, Openo KP, Ryan PA, Mumm E, Lynfield R, Salazar-Sanchez Y, Pacheco F, Keating F, Anderson BJ, Tesini BL, Felsen CB, Sutton M, Thomas A, Schaffner W, Talbot HK, Harbi K, Doran E, Weinberg GA, Staat MA, Payne DC, Halasa NB, Stewart L, Boom JA, Sahni LC, Klein EJ, Englund JA, Williams JV, Michaels MG, Schuster JE, Selvarangan R, Szilagyi PG, Havers FP, Dawood FS. Interim Evaluation of Respiratory Syncytial Virus Hospitalization Rates Among Infants and Young Children After Introduction of Respiratory Syncytial Virus Prevention Products — United States, October 2024–February 2025. MMWR Morb Mortal Wkly Rep. 2025 May 8;74(16):273–81. doi: 10.15585/mmwr.mm7416a1. PMCID: PMC12061057.
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According to new data from the CDC, the US infant mortality rate dropped slightly in 2024 after 2 years of hovering at a late-pandemic plateau. Some experts hypothesized that one reason for the drop could be a vaccination campaign against respiratory syncytial virus (RSV), a common cause of cold-like symptoms that can be dangerous for infants.
Even though the 2024 US infant mortality rate had a small drop, the United States still ranks around 60th compared to other countries. Some countries, such as Japan, Estonia, and Iceland, have infant mortality rates that are 75% lower than the US.
This article will review the respiratory syncytial virus and the RSV vaccine, then discuss the new data from the CDC.
What is respiratory syncytial virus?
The respiratory syncytial virus (RSV) is a common, contagious virus that causes respiratory tract infections. It is a single-stranded RNA virus whose name is derived from large cells known as syncytia, which form when infected cells fuse.
It usually causes mild, cold-like symptoms. However, it can cause serious lung infections, especially in infants, older adults, and people with serious medical problems. For seniors, RSV infections are dangerous as the immune systems weaken.
RSV spreads from person to person through:
- The air, by coughing and sneezing.
- Direct contact, such as kissing the face of a child who has RSV.
- Touching an object or surface with the virus, then touching your mouth, nose, or eyes before washing your hands.
RSV can sometimes lead to pneumonia (infection of the lungs) and congestive heart failure (when the heart can’t pump blood and oxygen to the body’s tissues).
According to the CDC, each year in the United States, RSV leads to approximately—
- 2.1 million outpatient visits among children younger than 5 years old
- 58,000 hospitalizations among children younger than 5 years old
- 177,000 hospitalizations among adults 65 years and older
- 14,000 deaths among adults 65 years and older
I know these numbers pale next to COVID-19, but before the pandemic, an RSV vaccine was often at the top of the wish list for a new vaccine. And for those people who had children or parents who had to deal with a serious RSV case, they probably wish they had access to a vaccine
There are four vaccines currently approved for use in the USA:
- Pfizer’s Abrysvo.
- GSK’s Arexvy.
- Moderna’s mRESVIA.
- Sanofi’s Beyfortus — this is not a traditional vaccine, because it does not activate the immune system, as would occur with infection or vaccination (active immunization). This is a monoclonal antibody that protects against the disease (passive immunization). It is usually given to infants and young children. Protection is likely most effective in the weeks after it is given and wanes over time. It is meant to protect infants when they are most at risk of getting severe RSV disease.
The CDC recommends a single dose of RSV vaccine for all adults aged 75 and older, as well as for those aged 60 to 74 years, who are at increased risk for severe RSV disease. All three of the above vaccines are approved for use in older adults.
The CDC also recommends one dose of the maternal RSV vaccine during weeks 32 through 36 of pregnancy, administered from September through January. Pfizer Abrysvo is the only RSV vaccine recommended during pregnancy.
Research has shown that the RSV vaccines protect against the disease, hospitalization from the disease, and death from RSV.
2024 US infant mortality statistics
The CDC reported on 8 May 2025 that the 12-month-ending US infant (age under one year) mortality rate in 2024 dropped from 5.63 per 1000 live births in 2023 to 5.49 per 1000 in 2024.
The CDC also reported that the neonatal (ages 0-27 days) mortality rate dropped from 3.66 per thousand in 2023 to 3.63 per thousand in 2024.
US infant deaths fell to about 19,900 last year, according to CDC data, compared with about 20,150 in 2023.
The 2022 and 2023 levels were up from 5.44 per 1,000 in 2021 — the first statistically significant jump in the rate in about two decades. Experts attributed those years to a rebound in RSV and flu infections after the two years of COVID pandemic precautions.
Moreover, the CDC began recommending two actions to reduce the burden of RSV on infants. As mentioned above, they began recommending the RSV vaccine for women between 32 and 36 weeks of pregnancy and the monoclonal antibody vaccine for infants.
Although we don’t have published data on the effect of the RSV vaccine on the overall infant mortality rate, Amanda Williams, MD, MPH, interim chief medical officer for the March of Dimes, stated that the RSV vaccine was partly responsible for the drop in the US infant mortality rate.
Coincidentally, the CDC published on 8 May 2025 in MMWR Morbidity and Mortality Weekly Report that infant hospitalizations in the 2024-25 respiratory virus season were more than 40% lower than past averages.
Summary
Although we will need more confirmatory evidence, the two reports from the CDC seem to indicate that the RSV vaccines were responsible for the drop in the US infant mortality rate in 2024.
I know that the infant mortality rate for the United States is way too high compared to other developed (and moderately developed) countries. Although it’s beyond the goals of this article, the high rate can be attributed to many factors — lack of health insurance, racism, poverty, lack of healthcare in economically disadvantaged areas, and so much more. I could write a book about it.
For now, we need to take the wins where we can. And the RSV vaccine is a winner.
Citations
- Patton ME, Moline HL, Whitaker M, Tannis A, Pham H, Toepfer AP, Taylor CA, Goldstein L, Reingold A, Kirley PD, Alden NB, Kawasaki B, Meek J, Kim D, Witt LS, Openo KP, Ryan PA, Mumm E, Lynfield R, Salazar-Sanchez Y, Pacheco F, Keating F, Anderson BJ, Tesini BL, Felsen CB, Sutton M, Thomas A, Schaffner W, Talbot HK, Harbi K, Doran E, Weinberg GA, Staat MA, Payne DC, Halasa NB, Stewart L, Boom JA, Sahni LC, Klein EJ, Englund JA, Williams JV, Michaels MG, Schuster JE, Selvarangan R, Szilagyi PG, Havers FP, Dawood FS. Interim Evaluation of Respiratory Syncytial Virus Hospitalization Rates Among Infants and Young Children After Introduction of Respiratory Syncytial Virus Prevention Products — United States, October 2024–February 2025. MMWR Morb Mortal Wkly Rep. 2025 May 8;74(16):273–81. doi: 10.15585/mmwr.mm7416a1. PMCID: PMC12061057.
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