The coronaviruses and the flu are two of the respiratory viruses Americans are facing. Thousands of children have been sent to hospitals due to the respiratory syncytial virus, which is a mystery to many.

R.S.V. is familiar to many children's doctors. It is one of the leading causes of infant mortality around the world.

More than 100,000 children under the age of 5 died in poor countries due to R.S.V.

One of the large killers that nobody knows about is pneumonia.

He said that you survive R.S.V. if you have access to care. Babies will die if those aren't present.

The virus poses particular risks to pregnant women and other people older than 65. There is no vaccine or treatment available. More than 30 preventive options are on the way after decades of stagnant progress.

The R.S.V vaccine was shown to be effective against hospitalization in infants under 90 days old and younger than six months.

The company plans to submit its vaccine for approval by the end of the year despite not meeting the FDA threshold for preventing doctor visits.

The efficacy of the R.S.V vaccine was reported in October. The F.D.A. is expected to start reviewing the vaccine by the end of the year.

R.S.V. was mostly at rest for the past two years. Children with severe R.S.V. illnesses are filling up hospitals earlier than usual. Young patients with little immunity against R.S.V are more sick than older patients.

Babies that survive an R.S.V. infections are more vulnerable to pneumonia. The consequences of infections are much more damaging than the infections themselves.

Children and adults who are exposed to R.S.V. multiple times are protected from serious illness. In the future, R.S.V. infections can rival those caused by flu in severity.

William Schaffner, an infectious diseases physician at the Vanderbilt University Medical Center in Nashville, said that they don't appreciate it as much because the diagnostics are not as available as they are for flu or Covidius.

R.S.V. is the leading cause of deaths among older adults. The drive to develop vaccines is due to the recognition of the problem.

Efforts to develop a vaccine for R.S.V. began in the 1960s but were unsuccessful. The field was further set back when the candidate vaccine increased the risk.

Scientists were able to design powerful vaccines thanks to a technical discovery at the National Institute of Health. The vaccine had an efficacy of about 94 percent against severe illness in people over the age of 70.

There is a vaccine that can be used to prevent respiratory disease in older adults.

Vaccines are being worked on for young children. A group led by Dr. Coleen Cunningham is working on a vaccine for children 6 to 24 months of age.

You don't have to worry about needles because it's not a shot. The vaccine might be more effective at preventing infections if it rouses the immune system in the nose.

Researchers are trying to find a balance between the strength of the virus and its ability to cause symptoms. The results so far are promising.

There isn't enough time for vaccines to build immunity in the youngest babies. A laboratory-made version of a powerful antidote to the viruses can be given to babies as an alternative to antibiotics.

Synagis was approved in 1998 and is injected once a month into infants who were born after 32 weeks of gestation or who have heart or lung problems that increase their risk. The antibody reduced hospitalization from R.S.V. infections.

Synagis is expensive so it's rarely used.

The cost of newer monoclonal antibodies may be lower. The European Medicines Agency recommended approval of a single dose of Beyfortus to protect children against R.S.V.

Immunizing pregnant women is one way to protect infants. Research shows that the baby can be protected for the first few months after birth if the mother's immune system crosses the placenta.

About 7,400 pregnant women received a single dose of the R.S.V. vaccine in the Pfizer trial. For six months after delivery, the researchers tracked the health of women and babies.

In the Northern and Southern Hemispheres, the trial took place in 18 countries. The Gates Foundation's Dr. Klugman hopes the vaccine will be available in poor countries by the year 2024.

Both the R.S.V. and flu vaccines seem to work together in tests so far. The duration of protection from an R.S.V vaccine is being worked on by others.

The scale of R.S.V. cases this year underscores the urgent need for vaccines and may serve to convince parents to immunize their children once vaccines are available.

When the vaccines arrive, there will be an opportunity for women to protect their babies.