RSV Vaccine Resources

Last Updated: July 9th, 2024

Respiratory Syncytial Virus (RSV)

Respiratory syncytial (sin-SISH-uhl) virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious. Infants and older adults are more likely to develop severe RSV and need hospitalization. Vaccines are available to protect older adults from severe RSV. Vaccines for pregnant people or monoclonal antibody products are available to protect infants and young children from severe RSV.

RSV is recognized as one of the most common causes of childhood illness and the most common cause of infant hospitalization. It causes annual outbreaks of respiratory illnesses in all age groups. In most regions of the United States, RSV season starts in the fall and peaks in the winter, but the timing and severity of RSV season in a given community can vary from year to year.

On this page, you will find:

RSV immunization recommendations to protect infants
RSV immunization recommendations to protect older adults

Immunizations to Protect Infants

There are two safe and effective immunizations to prevent RSV lower respiratory tract infection in infants. Either a maternal vaccination or a monoclonal antibody is recommended, but administration of both is not needed for most infants.

Maternal Vaccines for Pregnant People

One RSV vaccine (Abrysvo, Pfizer) is recommended for pregnant people who are 32–36 weeks pregnant with seasonal administration during September–January in most of the continental United States.

This vaccine provides protection against severe RSV illness to the recipient’s baby for up to 6 months of age. However, the infant’s protection will wane over time.

Healthcare providers of pregnant people should provide information on both maternal vaccines and infant monoclonal antibody products and consider patient preferences when determining whether to vaccinate the pregnant patient or to not vaccinate and rely on administration of nirsevimab to the infant after birth.

For more information, visit: https://www.cdc.gov/vaccines/vpd/rsv/hcp/pregnant-people.html

Monoclonal Antibody Products for Infants and Young Children

Nirsevimab (Beyfortus) is a monoclonal antibody product that can protect infants and some young children from severe RSV disease. It is recommended for:

Infants under eight months old born during – or entering – their first RSV season (typically fall through spring) if their mother did not receive an RSV vaccine, it is unknown if their mother received an RSV vaccine, or the mother received a vaccine, but the infant was born <14 days after vaccination
Nirsevimab can be considered in rare circumstances even though the mother received an RSV vaccine when, per the clinical judgment of the healthcare provider, the potential incremental benefit of administration is warranted
Pregnant people who may not mount an adequate immune response to vaccination (e.g., people with immunocompromising conditions) or have conditions associated with reduced transplacental antibody transfer (e.g., people living with HIV infection)
Infants who have had cardiopulmonary bypass leading to loss of RSV antibodies
Infants with substantially increased risk for severe RSV disease (e.g., hemodynamically significant congenital heart disease, intensive care admission, and requiring oxygen at discharge)

Some children between the ages of 8 and 19 months are at increased risk of severe RSV disease before their second RSV season. These include:

Children who have chronic lung disease of prematurity who require medical support (chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) any time during the 6-month period before the start of the second RSV season
Children with severe immunocompromise
Children with cystic fibrosis who have severe disease
American Indian and Alaska Native children

For more information, visit: https://www.cdc.gov/vaccines/vpd/rsv/hcp/child.html

Immunizations to Protect Older Adults

There are three RSV vaccines licensed for adults aged 60 years and older in the United States:

GSK's Arexvy
Pfizer's Abrysvo
Moderna's mRESVIA

For additional details on the Advisory Committee on Immunization Practices (ACIP) recommendations for RSV vaccination, see Adult RSV ACIP Vaccine Recommendations | CDC.

Adults aged 60 years and older

CDC recommends a single dose of RSV vaccines for:

All adults ages 75 and older
Adults ages 60-74 who are at increased risk of severe RSV disease

Risk factors for severe RSV disease

Epidemiologic evidence indicates that all adults ages 75 or older and adults ages 60-74 with certain risk factors are at increased risk of severe RSV. The following conditions increase the risk of severe RSV:

Cardiovascular disease (e.g., heart failure; coronary artery disease; congenital heart disease, excluding isolated hypertension)
Lung disease (e.g., chronic obstructive pulmonary disease [COPD], emphysema, asthma, interstitial lung disease, cystic fibrosis)
Advanced chronic kidney disease (e.g., stages 4–5, dependence on hemodialysis or other renal replacement therapy)
Diabetes mellitus with end-organ damage (e.g., diabetic nephropathy, neuropathy, retinopathy, or cardiovascular disease)
Severe obesity (body mass index ≥40 kg/m2)
Liver disorders (e.g., cirrhosis)
Neurologic or neuromuscular conditions (e.g., neuromuscular conditions causing impaired airway clearance or respiratory muscle weakness, excluding history of stroke without impaired airway clearance)
Hematologic disorders (e.g., sickle cell disease, thalassemia)
Moderate or severe immune compromise (either attributable to a medical condition or receipt of immunosuppressive medications or treatment)

As well as:

People who are frail*
People who reside in nursing homes or other long-term care facilities providing assistance with activities of daily living†
People with other chronic medical conditions or risk factors that a healthcare provider determines might increase the risk of severe disease due to respiratory infection

*Frailty is a multidimensional geriatric syndrome and reflects a state of increased vulnerability to adverse health outcomes. Although there is no consensus definition, one frequently used tool is the Fried frailty phenotype in which frailty is defined as a clinical syndrome with three or more of the following symptoms present: unintentional weight loss (10 lbs [4.5 kg] in the past year), self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity.

†Retirement communities and independent living communities for seniors are not considered long-term care facilities. Adults 60-74 living in these facilities may still be recommended to receive RSV vaccination if they have certain medical conditions listed above.

Timing of RSV vaccination and number of doses

For patients who have not already received an RSV vaccine and decide to get one, CDC encourages healthcare providers to maximize the benefit of RSV vaccination by giving them their RSV vaccine in late summer or early fall.

The RSV vaccine is not currently an annual vaccine, meaning eligible adults do not need to get a dose every RSV season. Currently, CDC recommends only a single dose of RSV vaccine for all adults ages 75 and older and adults ages 60-74 with increased risk of severe RSV disease. Additional surveillance and evaluation activities are ongoing to determine whether adults might benefit from receiving additional RSV vaccine doses in the future. So far, RSV vaccines appear to provide some protection for at least two RSV seasons.

For more information, visit: https://www.cdc.gov/vaccines/vpd/rsv/hcp/older-adults.html