There are multiple vaccines that help prevent or lessen the effect of certain infections on the lungs that have been shown to be safe and effective in children (see below for details). 

Unfortunately, there are still multiple respiratory infections for which we do not have vaccines. 

As a primary care pediatrician, I was part of giving thousands of routine vaccines to children and am very confident in their safety and efficacy. 

I support the American Academy of Pediatrics (AAP) Recommended Immunization Schedule first published in August of 2025. See more details at HealthyChildren.org - From the American Academy of Pediatrics.

RSV is a virus that has a strong propensity to affect the lungs of babies causing what is called bronchiolitis (inflammation of the bronchioles which are the smallest airways in the lungs). This causes babies to have trouble breathing and possibly low oxygen levels. 

Like influenza it is usually present during the winter/springs months (November to March) but can infect people outside of those months.

Most RSV infections start with cough and runny/stuffy nose but then can affect the lungs causing fast breathing, retractions (pulling in under the rib cage or in the lower throat), and grunting when breathing out. Usually babies will stop feeding or feed less when having these respiratory symptoms as well. Your pediatrician may hear crackles or wheezing when he/she listens to the lungs as well. Sometimes RSV will cause fevers but not all the time. In more severe cases the blood oxygen level can drop or RSV can cause apnea (when a baby stops breathing for 20+ seconds at a time).

Prior to the availability of RSV protection, there were an estimated 58,000 to 80,000 hospitalizations and 100 to 300 deaths in children aged <5 years each year (see figure below for more details). During my pediatric residency, I remember often having over half the hospitalized patients being babies with RSV bronchiolitis during the winter.

For decades there was research into developing a vaccine against RSV but none were approved due to lack of efficacy or due to side effects. 

In 2023 a monoclonal antibody called nirsevimab (brand name Beyfortis®) was approved to help protect babies against RSV. While also an injection like most vaccines, this is not technically a vaccine. Vaccines induce the body to produce cells and antibodies against an infection where nirsevimab contains pre-formed antibodies that protect against an RSV infection. In studies nirsevimab reduced hospitalization rates in babies due to RSV infection by 78%. 

It is approved for all babies <8 months of age during or right before the RSV season (October to March). It is a one-time injection that provides protection for at least 5 months.

In August of 2025, another monoclonal antibody against RSV was approved called clesrovimab (brand name Enflonsia®). It is also one-time injection that provides protection for at least 5 months.

Have your baby receive protection against RSV.

Influenza is an ever-mutating virus. It is usually present during the winter/springs months (November to March) but can infect people outside of those months.

Common symptoms of a flu infection include: fever, cough, sore throat, runny/stuffy nose, headaches, body aches, and fatigue. Some people will get nausea, vomiting and/or diarrhea but these symptoms are more rare. If you just have symptoms of a "stomach flu", then you most likely have a different infection that is not influenza.

In some cases, influenza can cause a much more severe illness with pneumonia (serious lung infection), myocarditis (inflammation of the heart muscle), encephalitis (inflammation of the brain tissue) and/or sepsis (life-threatening response to infection causing low blood pressure and decreased blood flow throughout the body). Those with chronic medical conditions have a higher risk of severe illness but even previously healthy persons can have severe illness with an infection with influenza.

The flu vaccine, while not perfect, can help reduce influenza illness and the severity of that illness. Since the influenza virus mutates at a relatively rapid rate and the flu vaccine takes months to produce, sometimes a dominant strain at the time of vaccine production is not the dominant strain during the next flu season. Also, the protection from the flu vaccine doesn't last for years like other vaccine protection does.

All that being said, the flu vaccine does reduce hospitalization for pediatric patients (those 17 years old or younger) by 53% (per article article Effectiveness of Influenza Vaccination in Preventing Hospitalization Due to Influenza in Children: A Systematic Review and Meta-analysis published in 2021 in the journal Clinical Infectious Diseases). Another study showed the flu vaccine reduced the risk of death in pediatric patients by 65% for those without high-risk conditions and by 51% for those with high-risk conditions (Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010-2014 published in the journal Pediatrics).

The 2024-2025 influenza season was particularly severe with 280 pediatric deaths which is the most in a season since with 2009-2010 season (which was when H1N1 influenza pandemic occurred). The median age of the children who passed away was 7 years old (meaning half were older than 7 and half were younger than 7). Of the deceased children whose flu vaccination status was known (208 of the 280), 89% of those eligible for vaccine did not receive the flu vaccine that season.

Don't let perfect be the enemy of good. Have your child vaccinated against flu each fall (September to November ideally but can/should be given from December to March as well). It is approved for anyone 6 months or older. If your baby is less than 6 months old, you should have all his/her caregivers vaccinated to help "shield" against a flu infection.

Pneumococcus is also a bacteria. Its technical name is streptococcus pneumoniae. It is related to the bacteria that causes "strep throat" but is not the same bacteria. It tends to cause disease in the lungs (thus the second part of its name being "pneumoniae"). There are multiples strains or "serotypes" of this bacteria. Because of the severity of the infection pneumococcus can cause, a vaccine was developed which has been modified to cover more strains or "serotypes" over the last 25 years.

The vaccine against pneumococcus is called the Pneumococcal Conjugate Vaccine (PCV). The number of strains or "serotypes" that it protects against is indicated by the number after "PCV".

The initial vaccine (PCV7) was licensed in 2000. In 2010 the PCV13 vaccine replaced the PCV7 vaccine. 

In 2022 the PCV15 vaccine was approved for children and in 2023 the PCV20 vaccine was approved for children. At this time (September 2025) the American Academy of Pediatrics recommends either vaccine without a preference for one over the other.

The PCV15 or PCV20 vaccine is given routinely at checks ups at 2 months, 4 months, 6 months, and 12-15 months.

The Pneumococcus bacteria usually enters the body by breathing it in, and it initially causes cough, runny nose, and fevers.

It often causes pneumonia (lung infection) but also has a high risk to then “invade” the body via the blood and travel to other organs, most dangerously the brain causing meningitis, especially in children under 2 years of age and adults 65 years or older.

Again, vaccination has made the number of serious illnesses from this bacteria almost disappear in children. The graph shows the annual cases rates of invasive pneumococcal disease (infection in the blood or brain) among children <5 years of age from 1998 to 2022. Information published by the Centers for Disease Control and Prevention (CDC) at https://www.cdc.gov/surv-manual/php/table-of-contents/chapter-11-pneumococcal.html?CDC_AAref_Val=https://www.cdc.gov/vaccines/pubs/surv-manual/chpt11-pneumo.html.

You can help protect your child against other infections that can damage their lungs.

Pertussis (whooping cough): in young infants, whooping cough can be very serious with about 1% of infected young infants dying from the infection; in older children it causes the "100 day cough", which sounds incredibly bothersome

Measles: in about 6% of cases, measles can infect the lungs causing pneumonia which is the most common cause of measles-associated death in children 

Varicella (chicken pox): though rare, a chicken pox infection can affect the lungs causing a pneumonia

COVID-19: can cause pneumonia at any age; causes high hospitalization rates in babies <12 months of age (see graph below from September 2025) which is higher than the rate for adults 50-64 years old (though lower than 65+ years old); can also damage to the heart muscle and blood clots