In recent years, significant strides have been made toward mitigating RSV’s impact via immunisation strategies. Since 2022, the European Union has authorised several prophylactic interventions aimed at curbing severe RSV manifestations in at-risk demographics. Among these are long-acting monoclonal antibodies, such as nirsevimab, administered prophylactically to neonates during the critical winter months, and maternal vaccines designed to confer passive immunity to infants through the transplacental transfer of neutralising antibodies. These immunisation approaches represent a pivotal evolution in combating a virus that previously eluded effective preventative measures.

A groundbreaking multicentre case-control study conducted across Belgium, Portugal, and Spain during the 2024/25 RSV season has elucidated the efficacy of nirsevimab immunisation in hospitalised children under two years of age. This landmark investigation, spearheaded by Savulescu et al. and published in Eurosurveillance, involved a robust cohort of over 4,100 hospitalised pediatric patients presenting with severe acute respiratory infections from September 2024 through May 2025. Out of these, 791 children tested positive for RSV and were further analysed alongside a control group of 1,410 RSV-negative children.

The study’s methodology involved classifying infants as immunised if they had received nirsevimab within the designated timeframe before RSV testing, irrespective of dosage or anthropometric variables such as age and weight. The longitudinal analysis underscored a compelling 79% overall reduction in hospitalisation risk attributable to RSV among immunised children versus controls. These findings decisively affirm the protective capability of monoclonal antibody prophylaxis during the RSV season, solidifying its role as a critical public health tool.

One of the more nuanced revelations from the study pertained to the durability of immunisation-induced protection. The protective efficacy of nirsevimab demonstrated a gradual decline over time post-administration. Initially, within the first month following immunisation, efficacy peaked at approximately 85%. However, this figure moderately decreased to 78% between 30 and 89 days, and further declined to 69% beyond the three-month mark. This temporal attenuation emphasizes the importance of understanding immunological kinetics to optimise timing and scheduling of prophylactic interventions.

Focusing on the highest-risk subgroup—newborns aged zero to six months—the effectiveness of immunisation was notably robust, with an 80% reduction in RSV-related hospitalisation rates documented. This demographic is disproportionately vulnerable due to underdeveloped adaptive immunity and heightened susceptibility to severe lower respiratory tract infections. Such efficacy substantiates the public health imperative of prioritising early-life immunisation programs incorporating long-acting monoclonal antibodies.

The authors advocate for continued surveillance and monitoring of immunisation effectiveness in subsequent seasons to better delineate patterns of waning immunity. This ongoing evaluation is critical to adapting public health policies, including potential booster strategies and refining age cohorts targeted by immunisation efforts. Additionally, the surveillance provides valuable data to anticipate RSV epidemic peaks and allocate healthcare resources more effectively.

Immunisation with monoclonal antibodies not only reduces hospital admissions but also mitigates the severe disease burden on infants by interfering with the virus’ ability to bind and enter respiratory epithelial cells, thus neutralising infection at an early stage. This prophylactic mechanism bypasses the need for an active immune response, an advantageous feature in neonates with immature immune systems, thereby ensuring immediate and sustained protection during the peak RSV circulation period.

The European Centre for Disease Prevention and Control (ECDC) continues to play a pivotal role in orchestrating vaccine effectiveness and burden studies, exemplified by funding the VEBIS project underpinning this research. This collaborative effort across multiple countries enhances the generalisability of findings and provides a scientifically rigorous basis to inform EU-wide immunisation guidelines and policy formulation.

Furthermore, the resurgence of RSV activity resembling pre-pandemic seasonal patterns underscores the virus’s persistence and the necessity for sustained immunisation vigilance. Post-pandemic shifts in respiratory virus epidemiology have prompted recalibrations in surveillance and vaccination strategies to address the heightened susceptibility resulting from altered exposure dynamics during COVID-19 related preventative measures.

The implications of this study extend beyond pediatric immunisation, signaling potential advancements in RSV prophylaxis for other vulnerable groups such as the elderly and immunocompromised individuals, where vaccine efficacy remains under active investigation. Monoclonal antibodies, with their targeted specificity and potential for durable protection, may represent an evolving cornerstone in comprehensive RSV disease management.

In summation, the 2024/25 European multicentre study unequivocally demonstrates that immunisation with long-acting monoclonal antibodies significantly diminishes severe RSV illness necessitating hospital admission in infants. The temporal decline in efficacy observed warrants strategic enhancements in immunisation scheduling and ongoing efficacy monitoring. These findings translate into actionable knowledge pivotal for reducing RSV morbidity, alleviating healthcare burden, and safeguarding the most vulnerable populations during the respiratory virus season.

Subject of Research: People
Article Title: Effectiveness of long-acting monoclonal antibodies against laboratory-confirmed RSV in children aged < 24 months and hospitalised for severe acute respiratory infection, European pilot study, 2024 to 2025
News Publication Date: 13-Nov-2025
Web References:

• https://www.eurosurveillance/content/10.2807/1560-7917.ES.2025.30.45.2500816
• https://www.ema.europa.eu/en/medicines/human/EPAR/beyfortus
• https://www.ema.europa.eu/en/search?keywords=Abrysvo
  References:
  Savulescu Camelia, Ganser Iris, Nicolay Nathalie, et al. Effectiveness of long-acting monoclonal antibodies against laboratory-confirmed RSV in children aged < 24 months and hospitalised for severe acute respiratory infection, European pilot study, 2024 to 2025. Euro Surveill. 2025;30(45). DOI: 10.2807/1560-7917.ES.2025.30.45.2500816
  Image Credits: Eurosurveillance
  Keywords: Respiratory syncytial virus, Immunisation, Monoclonal antibodies, Infants, Infectious diseases, Public health, Epidemiology, Health care, Human health

RSV has long been identified as a chief culprit behind bronchiolitis and pneumonia in infants, leading to significant morbidity and hospitalization worldwide. Prior to the COVID-19 pandemic, RSV exhibited predictable seasonal epidemics, predominantly occurring during the winter months in temperate climates. However, the unprecedented non-pharmaceutical interventions implemented globally—from social distancing to lockdowns and mandatory masking—curtailed the transmission of numerous respiratory viruses, including RSV. This interruption not only suppressed RSV activity but also profoundly affected herd immunity patterns in populations, particularly neonates and young infants with immature immune systems.

Emerging evidence post-pandemic underscores a disturbing resurgence of RSV, often marked by atypical seasonality and unexpected spikes in incidence. Karageorgos and Koutroulis meticulously analyzed clinical data on neonates aged two months and younger, captured across multiple centers in the post-COVID era. Their research delineates a notable shift: instead of the customary winter peak, RSV outbreaks now manifest during spring or even summer months. This temporal shift poses challenges for healthcare systems that anticipate and prepare for RSV surges within predictable windows. Moreover, the altered timing questions the stability of existing prophylactic measures that are traditionally aligned with historic seasonal cycles.

The mechanisms underlying these epidemiological shifts are multifactorial. Firstly, population immunity has been affected; interrupted viral circulation over consecutive seasons led to a cohort of infants lacking previous RSV exposure or passive immunity from maternal antibodies, due to decreased maternal contact with the virus during pregnancy. This immunological naivety appears to increase susceptibility and severity of illness in young infants upon eventual exposure. Secondly, behavioral changes in populations, coupled with variable implementation of public health protocols internationally, have fragmented the homogeneity of viral transmission dynamics, creating microepidemics at nontraditional times.

Clinically, the post-pandemic RSV landscape revealed by Karageorgos and Koutroulis is disconcerting. Hospitalization rates in infants ≤2 months have escalated, with a subset experiencing more severe respiratory distress requiring intensive care support. This uptick in severity may reflect a combination of immunological gaps and delayed exposure, wherein older susceptible infants manifest more robust inflammatory responses. Additionally, the researchers note that co-infections with other respiratory pathogens, sometimes including SARS-CoV-2, can complicate clinical manifestations, demanding heightened diagnostic vigilance and tailored therapeutic strategies.

Advanced molecular diagnostics employed in the study have also unraveled new insights into viral genomics and strain variation. While RSV traditionally exists as two primary subtypes—A and B—the post-pandemic profile demonstrates fluctuating dominance and emergence of novel sublineages, possibly influenced by evolutionary pressures in an immunologically altered host population. These changes bear significant implications for vaccine development, which remains a high priority yet challenging frontier due to the virus’s antigenic variability and the fragility of the target infant group.

Another critical dimension investigated involves the long-term respiratory sequelae following neonatal RSV infection. The authors discuss potential exacerbation of chronic respiratory conditions such as wheezing and asthma, hypothesizing that the altered infection patterns and immune responses may modulate pulmonary development differently. This concern prompts calls for longitudinal surveillance and integrative pediatric care models to preempt and manage respiratory morbidity stemming from early-life RSV disease.

In terms of prevention, the research highlights the crucial role of maternal immunization and the use of monoclonal antibodies such as palivizumab in shielding high-risk neonates. Nonetheless, the shifting epidemiology challenges the timing and coverage of these interventions, suggesting an urgent need to revisit prophylactic protocols to optimize protection throughout the now more variable RSV seasons. The data propose that dynamic monitoring and adaptable immunization strategies will be integral to counteract this mutable viral threat.

Furthermore, the study explores the broader public health implications of RSV resurgence post-COVID-19. Hospital resource allocation, especially pediatric intensive care units, must anticipate surges beyond traditional flu seasons. It immediately accentuates the importance of integrated respiratory virus surveillance networks to detect and respond rapidly to atypical outbreaks. Global collaboration and data sharing gain unprecedented significance in forming a coherent, agile public health response.

The socio-economic consequences of escalating RSV disease burden in infancy are discussed in detail, including parental work absenteeism, healthcare costs, and the psychological stress associated with severe neonatal illness. These ripple effects reinforce the necessity for comprehensive strategies that address not only medical but also societal dimensions of RSV mitigation in a post-pandemic world.

In dissecting the intersection of viral immunology, epidemiology, and clinical outcomes, Karageorgos and Koutroulis’s groundbreaking research offers an essential framework for future studies. It calls for intensified focus on understanding how respiratory viruses adapt and reemerge following large-scale disruptions caused by global pandemics. Their work advocates for leveraging innovative technologies in viral surveillance, enhanced clinical risk stratification, and accelerated vaccine development pipelines.

As the global community continues to nurse fragile health systems recovering from COVID-19 repercussions, the patterns unveiled by this meticulous study serve as a stark reminder that respiratory viruses remain unpredictable foes. RSV’s post-pandemic reconfiguration demands vigilance and swift adaptation from clinicians, researchers, and policymakers alike. The findings underscore a broader concept: infectious diseases exist in dynamic ecological balances that can be radically altered, sometimes with unintended consequences, by human intervention on a planetary scale.

Ultimately, the insights from this research complement an emerging paradigm where pandemic preparedness must extend beyond a single pathogen perspective to encompass the entire respiratory infectious disease ecosystem. In doing so, the healthcare community can better anticipate, prevent, and mitigate the impacts of both known and emerging viral threats on vulnerable populations, particularly the most fragile infants at the dawn of life.

The detailed clinical data, epidemiological analyses, and virological insights presented by Karageorgos and Koutroulis herald a new chapter in our understanding of respiratory syncytial virus in infancy, emphasizing that the post-COVID-19 world harbors altered infectious challenges that require a recalibrated scientific and medical approach.

Subject of Research: Respiratory syncytial virus (RSV) epidemiology and clinical outcomes in infants aged two months or younger in the post-COVID-19 pandemic era.

Article Title: Respiratory syncytial virus in infants ≤2 months in the post-COVID-19 pandemic era: shifting patterns and outcomes.

Article References:
Karageorgos, S., Koutroulis, I. Respiratory syncytial virus in infants ≤2 months in the post-COVID-19 pandemic era: shifting patterns and outcomes. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04471-6

Image Credits: AI Generated

RSV remains a formidable adversary, responsible for significant morbidity and mortality, particularly in infants under the age of one. This pathogen primarily affects the lower respiratory tract, precipitating bronchiolitis and pneumonia, conditions that often necessitate hospitalization. The seasonal and ubiquitous nature of RSV infections, combined with the virus’s capacity to reinfect throughout life, places a massive burden on healthcare infrastructure globally. The expert panel draws attention to epidemiological data underscoring that RSV is a dominant cause of hospitalization in infants, especially those born prematurely or with underlying cardiopulmonary conditions. The resultant strain on hospital resources, including intensive care units, is a key healthcare challenge that necessitates urgent intervention strategies.

One of the critical insights explored is the inadequacy of traditional preventive measures such as hand hygiene, infection control protocols, and existing immunoprophylaxis methods. For decades, the monoclonal antibody palivizumab was the mainstay for prophylaxis against RSV in high-risk infants; however, its limitations — notably the requirement for monthly injections throughout the RSV season and limited accessibility in low-resource settings — have constrained its global impact. The novel introduction of nirsevimab changes this landscape. Engineered to provide potent neutralizing activity against RSV with a significantly extended half-life, nirsevimab requires only a single dose per RSV season, enhancing compliance and feasibility.

The mechanism underpinning nirsevimab’s efficacy lies in its targeted binding to the prefusion conformation of the RSV F protein. This prefusion form, present on the viral surface before fusion with host cells, is highly antigenic and critical for viral entry. By stabilizing this conformation and preventing fusion with respiratory epithelial cells, nirsevimab effectively neutralizes the virus. The expert consensus highlights molecular data revealing that this mechanism confers broad neutralization against both RSV subgroups A and B, which dominate seasonal epidemics. This molecular precision marks a leap forward from previous antibodies that targeted the postfusion protein, which exhibits lower neutralization potency.

Clinical trials underpinning the widespread optimism around nirsevimab have demonstrated robust safety and effectiveness in diverse populations. Large-scale, randomized controlled trials involving healthy term and preterm infants show that a single intramuscular injection before the RSV season reduces medically attended RSV lower respiratory tract infections by more than 70%. Moreover, hospitalization rates were dramatically decreased, signifying a reduction in disease severity and healthcare utilization. The consensus report emphasizes that this evidence supports recommending nirsevimab not only for high-risk infants but also for all infants entering their first RSV season, thereby potentially reshaping public health immunization guidelines.

The panel also reflects on the critical public health implications of integrating nirsevimab into routine clinical practice. Such prophylaxis has the potential to alleviate the seasonal spikes in pediatric hospital admissions attributable to RSV, particularly in the youngest and most vulnerable populations. This could substantially ease the healthcare system’s seasonal burden, optimizing resource allocation. Furthermore, by reducing RSV incidence and severity, nirsevimab may also reduce the risk of subsequent complications such as recurrent wheezing or asthma, a hypothesis supported by emerging longitudinal data, though requiring further investigation.

From a global health perspective, the consensus draws attention to the equity challenges in RSV prevention. Many low- and middle-income countries bear a disproportionate burden of RSV-associated mortality, often exacerbated by limited access to preventive therapies. The simplicity of a single-dose regimen with nirsevimab, coupled with its durable protection, makes it a compelling tool to extend RSV prophylaxis in resource-limited settings. The report advocates for strategies to support equitable distribution, affordable pricing, and integration into existing immunization platforms to maximize global impact.

In addition to direct infant protection, the consensus recognizes the potential role of nirsevimab in broader RSV management strategies. The virus is also a significant cause of morbidity in older adults, and understanding nirsevimab’s use in different age groups remains an area of ongoing research. Nonetheless, the experts underscore that the greatest immediate benefit lies in early infancy, where the viral burden and immune vulnerability peak. The preventive approach enabled by nirsevimab aligns with contemporary shifts toward preemptive immunotherapeutics that reduce disease incidence rather than merely ameliorating symptoms post-infection.

Beyond efficacy, safety data presented in the consensus affirm nirsevimab’s favorable profile. Adverse effects were predominantly mild and transient, with injection site reactions being the most common. Immunogenicity assessments revealed low anti-drug antibody formation, minimizing concerns about reduced efficacy or hypersensitivity with repeated dosing across subsequent seasons. This safety profile supports widespread adoption among practitioners and caregivers, enhancing confidence in this novel intervention.

The consensus further elaborates on the challenges and considerations for surveillance post-implementation. Monitoring for potential viral resistance mutations, shifts in RSV epidemiology, or changes in strain dominance is critical to sustaining nirsevimab’s effectiveness. The panel recommends robust genomic surveillance infrastructures and real-world effectiveness studies to rapidly detect and respond to such developments. This proactive vigilance will be essential to maintaining long-term disease control and tailoring immunization strategies as needed.

Economic evaluations form another layer of analysis in the expert consensus. Modeling studies suggest that despite upfront costs associated with nirsevimab administration, the overall economic impact favors cost-effectiveness due to reductions in hospitalizations, intensive care admissions, and long-term respiratory morbidity. Such data are pivotal for policymakers and healthcare payers considering national immunization program inclusion. The consensus highlights the need for ongoing health economic research in diverse healthcare contexts to refine these estimates further.

The publication also touches on ongoing developments to optimize RSV prevention, including vaccine candidates targeting different viral antigens and immunization strategies focused on pregnant women to confer passive immunity to neonates. While these approaches show promise, the consensus emphasizes that nirsevimab currently represents the most immediately scalable and effective preventive option for infants. Integration of these modalities in the future could yield synergistic benefits, though timelines for broad vaccine availability remain uncertain.

Finally, the expert panel’s consensus carries a hopeful message: With the advent of nirsevimab, healthcare providers are equipped with a powerful new tool to reduce the devastating impact of RSV on infants worldwide. This paradigm shift toward long-acting monoclonal antibodies as frontline RSV prophylaxis may exemplary pave the way for similar innovations against other pediatric viral threats. The multidisciplinary collaboration underlying this progress underscores the importance of sustained investment in translational research, equitable healthcare policies, and vigilant post-market surveillance to ensure that all infants reap the benefits of these scientific breakthroughs.

As the world awaits broader implementation and real-world data, the promise of nirsevimab shines as a beacon of progress in pediatric infectious disease management. Its capacity to prevent a once-unrelenting pathogen offers hope for healthier beginnings for countless infants globally, marking a significant milestone in the ongoing journey toward conquering respiratory viral diseases.

Subject of Research: Respiratory syncytial virus (RSV) disease burden and the preventive utility of nirsevimab in infants

Article Title: Expert consensus on the burden of respiratory syncytial virus disease and the utility of nirsevimab for disease prevention and protection of infants

Article References:
Goh, D.Y.T., Goh, A., Chen, C.K. et al. Expert consensus on the burden of respiratory syncytial virus disease and the utility of nirsevimab for disease prevention and protection of infants. World J Pediatr 21, 552–565 (2025). https://doi.org/10.1007/s12519-025-00926-2

Image Credits: AI Generated

DOI: June 2025

Respiratory Syncytial Virus is recognized as a leading cause of lower respiratory tract infections in infants and young children globally. The virus notoriously causes bronchiolitis and pneumonia, often resulting in hospitalizations that can overwhelm pediatric care systems each year during seasonal peaks. Despite decades of research into RSV pathogenesis and transmission dynamics, critical gaps have persisted in understanding how the risk of severe disease changes not just with the infant’s age in months but also with their month of birth, a factor linked with seasonal viral circulation patterns and possible immunological factors.

This study leverages a robust dataset encompassing hospital admissions for RSV-associated illness across multiple birth cohorts, dissecting how the risk of hospitalization evolves throughout the first months of life. The investigators applied statistical modeling that accounted for confounders such as gestational age, socioeconomic status, and underlying health conditions. Their findings reveal a nuanced interplay between chronological age and birth timing, with the highest hospitalization rates observed among infants born just before or during peak RSV season who subsequently encounter the virus at a vulnerable immunological window.

One of the most compelling revelations from the study is the pronounced increase in RSV hospitalizations around the second and third months after birth, emphasizing the immature state of the neonatal immune system and its inadequate initial antibodies against RSV. Infants born in fall months, particularly September and October, faced the greatest risk since their first exposure coincided with the peak viral activity in winter, a critical period when passive maternal antibody protection wanes and infants have not yet mounted sufficient adaptive immunity.

The research team also explored immunological aspects underpinning these epidemiological patterns, discussing how maternal antibody levels transferred transplacentally decline rapidly in the first weeks postpartum, leaving a narrow window of susceptibility. This biological phenomenon aligns with epidemiological data demonstrating that infants who encounter RSV infection after this antibody decline phase are significantly more likely to develop severe disease necessitating hospitalization. Furthermore, the investigators contemplate factors such as environmental exposures, daylight variation influencing immune responses, and viral burden intensity as modifiers of disease severity linked to birth month.

In terms of public health implications, the findings present a compelling argument for optimizing prophylactic strategies like monoclonal antibody administration and emerging vaccines. Current prophylactic measures are often administered based on chronological age criteria; however, this study suggests an enhanced risk stratification approach that includes birth month as a key determinant could significantly improve target populations for intervention. For example, infants born just prior to RSV season could be prioritized for passive immunization to bridge the critical vulnerability gap in early infancy.

Importantly, the study also underscores challenges in the timing of active RSV vaccines in development. Since immunization efficacy is influenced by both the maturity of the infant immune system and the anticipated viral exposure window, understanding how protection wanes relative to birth month and seasonal viral circulation can guide scheduling to ensure maximal vaccine impact. The authors advocate for incorporating these epidemiological insights into clinical trial designs and immunization policies, potentially shifting paradigms in RSV prevention.

From a virological perspective, the research further contributes to understanding RSV seasonality. The virus is characterized by pronounced annual peaks, often in the cold months in temperate climates, driven by factors including indoor crowding, humidity, and virus stability in the environment. By analyzing hospitalizations aligned to infant birth months, the authors uniquely correlate individual exposure timing with population-level viral transmission dynamics, highlighting the importance of synchronizing intervention timing with epidemiological trends.

Moreover, the methodology utilized is notable for integrating multi-layered data—a first in RSV hospitalization studies. Combining individual-level clinical data with temporal birth cohorts and robust statistical modeling allowed the researchers to control for biases such as varying healthcare-seeking behavior and surveillance intensity across seasons. Their approach sets a new standard for respiratory virus epidemiology research, providing a template for studying other pathogens with seasonal behavior patterns.

Beyond immediate clinical ramifications, the data yield insights into the biological and environmental determinants of infant immunity. The intersection of age-related immune system maturation and seasonal external factors—ranging from viral prevalence to ambient temperature—underscore the complexity underlying respiratory infection risk. These findings invite further mechanistic studies exploring how seasonally modulated immune ontogeny and exposure history influence susceptibility to RSV and subsequent immune memory formation.

The study also touches on the implications for health equity and resource allocation. In many regions, RSV imposes a disproportionate burden on vulnerable populations, often linked to socioeconomic factors that affect healthcare access and environmental exposures. The researchers note that birth month-based risk stratification could enable more precise allocation of limited prophylactic resources to those infants most at risk, potentially reducing disparities in RSV-associated morbidity and mortality.

Overall, the extensive data and rigorous analyses presented offer a transformative understanding of RSV infection risk that transcends simplistic age-based categories. By illuminating how birth month confers differential vulnerability mediated through complex immunological and environmental mechanisms, the study equips clinicians, public health officials, and vaccine developers with refined knowledge to craft tailored prevention strategies. As RSV remains a formidable challenge globally, advancements derived from such comprehensive research are essential in moving toward effective and equitable control of this ubiquitous pediatric pathogen.

The publication’s multidisciplinary authorship team, combining expertise in virology, immunology, pediatrics, and epidemiology, underscores the collaborative nature required for tackling intricate infectious disease questions. Their work exemplifies how large-scale data analysis coupled with biological insight can reveal subtle but critical determinants of disease risk, ultimately informing interventions that save lives and optimize healthcare delivery in vulnerable infant populations.

As efforts accelerate globally toward RSV vaccines and novel therapeutics, the implications of this study resonate profoundly. It advises a reconsideration of existing prophylaxis frameworks, urging stakeholders to incorporate nuanced risk factors beyond simple age cutoffs, thereby enhancing the precision and effectiveness of interventions. The research thereby lays the groundwork for dynamic prevention paradigms sensitive to temporal and biological contexts that characterize RSV infection in early life.

In conclusion, this landmark study expands the frontiers of RSV epidemiology by demonstrating how chronological age and birth month jointly dictate hospitalization risk in infants. It challenges existing paradigms and establishes evidence-based directives for personalized approaches to RSV prevention, with profound potential to reduce infant morbidity and mortality worldwide. Such insights are pivotal at a time when RSV remains a critical public health concern despite ongoing vaccine development efforts, underscoring the continual need for in-depth investigation into the complex factors influencing infectious disease outcomes.

Subject of Research:
Hospitalization patterns of Respiratory Syncytial Virus in infants analyzed by chronological age and birth month.

Article Title:
Respiratory syncytial virus hospitalisation by chronological month of age and by birth month in infants.

Article References:
Guo, L., Kenmoe, S., Miyake, F. et al. Respiratory syncytial virus hospitalisation by chronological month of age and by birth month in infants. Nat Commun 16, 6109 (2025). https://doi.org/10.1038/s41467-025-61400-1

Image Credits:
AI Generated