The Rise of Adult RSV Vaccines: Who Needs One This Season?

Respiratory Syncytial Virus (RSV) was once viewed strictly as a concern for infants and toddlers. However, recent medical data has highlighted the severe risks it poses to older adults and newborns. With the release of new guidelines from the Centers for Disease Control and Prevention (CDC), understanding your eligibility for the RSV vaccine is essential for protecting yourself and your family this winter.

Understanding the New CDC Guidelines for Older Adults

In June 2024, the CDC updated its recommendations regarding RSV vaccinations for adults. Previously, the advice was based on “shared clinical decision-making” between a patient and their doctor. The new guidance provides much clearer instructions to eliminate confusion and increase vaccination rates among the most vulnerable populations.

The current recommendation is not an annual shot like the flu vaccine. As of late 2024, the CDC views the RSV vaccine as a single dose. If you received a dose last year, you do not need another one this season.

Who Should Get the Vaccine?

The CDC breaks down eligibility into two distinct groups based on age and risk profile:

  • Adults aged 75 and older: The vaccine is recommended for everyone in this age group. The risk of hospitalization from respiratory illness increases significantly after age 75, making this a standard preventative measure.
  • Adults aged 60 to 74 with chronic conditions: If you fall into this age bracket, you should get the vaccine if you have specific risk factors that make severe RSV illness more likely.

Qualifying Risk Factors

For those between 60 and 74, the need for a vaccine depends on your medical history. You are considered at increased risk if you manage any of the following conditions:

  • Chronic lung diseases: This includes COPD (chronic obstructive pulmonary disease) and asthma.
  • Cardiovascular issues: Heart failure and coronary artery disease significantly weaken the body’s ability to fight respiratory infections.
  • Diabetes: Particularly if it is accompanied by other organ damage.
  • Compromised immune system: This applies to individuals undergoing cancer treatment, organ transplant recipients, or those taking immunosuppressive medication.
  • Residence in care facilities: Living in a nursing home or long-term care facility increases exposure risk.

The Available Vaccines: Know the Brands

Currently, there are three major FDA-approved RSV vaccines available for older adults. While they all serve the same purpose, they come from different pharmaceutical manufacturers.

  1. Arexvy (GSK): This was the first RSV vaccine approved for use in the United States. It contains an adjuvant, which is an ingredient used to create a stronger immune response.
  2. Abrysvo (Pfizer): This vaccine is unique because it is the only one approved for both older adults and pregnant women (for the protection of the infant). It does not contain an adjuvant.
  3. mRESVIA (Moderna): Approved in 2024, this is the newest option. It utilizes mRNA technology, similar to the technology used in Moderna’s COVID-19 vaccines.

For most adults over 60, any of these three options are acceptable. However, availability may vary depending on your local pharmacy or clinic.

Protecting Newborns: Vaccination During Pregnancy

RSV is the leading cause of hospitalization for infants in the United States. To combat this, the FDA and CDC have approved the Pfizer vaccine (Abrysvo) for use during pregnancy. This strategy is known as maternal immunization. By vaccinating the mother, protective antibodies are passed through the placenta to the fetus, protecting the baby for the first six months of life when they are most vulnerable.

Timing is Critical

The window for maternal RSV vaccination is very specific. Pregnant women should receive the vaccine:

  • Between 32 and 36 weeks of gestation.
  • During RSV season: This is typically defined as September through January in most of the United States.

If a mother receives the vaccine during pregnancy, the newborn generally does not need the separate infant antibody immunization known as nirsevimab (brand name Beyfortus). However, if the mother is not vaccinated, or if the baby is born less than two weeks after the shot, the infant should receive nirsevimab shortly after birth.

Side Effects and Safety Monitoring

Clinical trials have shown these vaccines to be safe and effective, but like all medical interventions, they can carry side effects. Most reactions are mild and resolve within a day or two.

Common side effects include:

  • Pain, redness, or swelling at the injection site.
  • Fatigue or muscle pain.
  • Headache.
  • Nausea.

In rare instances during clinical trials, a small number of participants developed Guillain-Barré syndrome (GBS), a neurological disorder. While the statistical risk is very low, the CDC and FDA continue to monitor safety data closely. The consensus remains that the benefit of preventing severe RSV pneumonia and hospitalization far outweighs the low risk of severe side effects.

Cost and Insurance Coverage

For the vast majority of older adults, the RSV vaccine is free.

  • Medicare Part D: The vaccine is fully covered under Medicare Part D plans. Unlike Part B, which covers flu and pneumonia shots, the RSV shot falls under prescription drug plans. Thanks to the Inflation Reduction Act, there are no out-of-pocket costs or deductibles for recommended adult vaccines under Part D.
  • Private Insurance: Most private health plans are required to cover ACIP-recommended vaccines with no copay or deductible, provided you go to an in-network provider.
  • Uninsured Costs: If you do not have insurance, the out-of-pocket cost can be steep. The retail price for a single dose of Arexvy or Abrysvo typically ranges between $280 and $330 depending on the pharmacy. However, some community health centers may offer sliding scale fees.

When to Get Vaccinated

RSV is a seasonal virus that typically spikes in late fall and winter. The CDC suggests receiving the vaccine in late summer or early fall (August, September, or October) to ensure maximum immunity before virus transmission peaks.

Since the vaccine does not currently require an annual booster, checking your records is important. If you received an RSV shot in the fall of 2023, you are considered protected for the 2024-2025 season and should not get another dose at this time.

Frequently Asked Questions

Can I get the RSV vaccine at the same time as my flu shot? Yes. You can receive the RSV vaccine, the flu shot, and the COVID-19 vaccine during the same visit. However, you might experience slightly more side effects, such as fatigue or a sore arm, if you get them all at once.

Is the RSV vaccine annual like the flu shot? No. Currently, the CDC recommends the RSV vaccine as a single lifetime dose for eligible adults. Ongoing research determines if booster shots will be necessary in future years.

Which vaccine is best for pregnant women? Only Pfizer’s Abrysvo is approved for use during pregnancy. GSK’s Arexvy and Moderna’s mRESVIA are not approved for maternal immunization.

Does the vaccine prevent infection entirely? The primary goal of the vaccine is to prevent severe disease. While you might still contract a mild case of RSV, the vaccine is highly effective at keeping you out of the hospital and preventing life-threatening complications like pneumonia.