Frequently Asked Questions About RSV Vaccine for Adults

RSV is a common cause of respiratory illness in infants and young children, as well as older adults. Each season, RSV causes substantial morbidity and mortality in older adults, including lower respiratory tract disease, hospitalization, and death. There are an estimated 60,000–160,000 hospitalizations and 6,000–10,000 deaths annually due to RSV among adults ages 65 years and older.

CDC recommends RSV vaccination for all adults ages 75 and older and for adults ages 60-74 who are at increased risk of severe RSV disease. Three respiratory syncytial virus (RSV) vaccines are approved for adults ages 60 years and older:

• GSK’s AREXVY (protein subunit RSV vaccine, adjuvanted)
• Pfizer’s ABRYSVO (protein subunit RSV vaccine)
• Moderna’s mRESVIA (mRNA RSV vaccine)

All three of these vaccines cause the immune system to produce RSV antibodies. All three are currently approved as a single dose and were shown in clinical trials to protect against symptomatic lower respiratory tract disease caused by RSV in adults ages 60 and older. Based on clinical trial data, one dose of RSV vaccine can provide protection for at least 2 years.

Storage and handling of each RSV vaccine may differ.

CDC does not have a preferential recommendation for any specific vaccine. Eligible adults should receive whichever vaccine is available.

Although RSV infection generally causes mild upper respiratory disease in healthy adults, RSV can cause serious illness in adults with certain underlying medical conditions or other risk factors.

Eligible adults can get an RSV vaccine at any time, but the best time to get vaccinated is in late summer and early fall before RSV usually starts to spread in communities. In most of the continental US, this means the ideal time for vaccination is between August and October.

RSV vaccine is not currently an annual vaccine, meaning adults ages 60 and older do not need to get a dose every RSV season.

The most common side effects after RSV vaccination reported from clinical trials included pain, redness, and swelling where the shot is given, fatigue, fever, headache, nausea, diarrhea, and muscle or joint pain. These side effects were usually mild.

Serious neurologic events, including Guillain-Barré syndrome (GBS) and other inflammatory neurologic events, were reported after RSV vaccination with GSK’s AREXVY and Pfizer’s ABRYSVO in clinical trials. No GBS cases were reported in clinical trials within 42 days after vaccination with Moderna mRESVIA. Preliminary safety surveillance data from the Vaccine Adverse Event Reporting System (VAERS) (co-managed by CDC and FDA) and the Vaccine Safety Datalink (VSD), as well as from a partnership between FDA and the Centers for Medicaid and Medicare Services (CMS), suggest a potential increased risk of GBS after vaccination with GSK’s AREXVY and Pfizer’s ABRYSVO in older adults. Due to uncertainties and limitations, these analyses cannot establish if there is an increased risk for GBS after RSV vaccination.

CDC and FDA are conducting population-based active surveillance to monitor for GBS following RSV vaccination. Additional analyses using these surveillance data are underway and will provide more information about whether there is an association between RSV vaccines and GBS.

Until additional evidence is available to clarify the risk of inflammatory neurologic events after vaccination, RSV vaccination in older adults should be directed to those who are at highest risk for severe RSV disease and therefore most likely to benefit from vaccination. As for all FDA-approved vaccines, CDC will conduct post-marketing safety surveillance to further inform RSV vaccine recommendations. For more information, see CDC’s vaccine safety surveillance webpages.

You should administer RSV vaccine intramuscularly in the deltoid region of the upper arm with a 1- to 1.5-inch needle. For additional information on vaccine administration, see job aid on giving intramuscular vaccines to adults.

GSK’s AREXVY and Pfizer’s ABRYSVO require reconstitution of a lyophilized component and a diluent using materials provided in the vaccine packaging.

Moderna’s mRESVIA does not require reconstitution.

See Storage and Handling for more information on each vaccine.

Currently, CDC recommends only a single dose of RSV vaccine for all adults ages 75 and older and adults ages 60-74 who are at increased risk of severe RSV disease. Based on clinical trial data, one dose of RSV vaccine can provide protection for at least 2 years. Studies are ongoing to determine whether people ages 60 and older would benefit from receiving additional RSV vaccine doses in the future.

Administration of RSV vaccine on the same day with other adult vaccines is acceptable. However, according to results of coadministration studies of RSV vaccines with influenza vaccines, common side effects, such as fever and soreness at the injection site, may be increased when these two vaccines are administered on the same day. Some studies also suggest it’s possible that the RSV and flu vaccines may not produce as strong of an immune response if they’re given on the same day, but the clinical significance of this is unknown. Additional research is ongoing to further inform guidance on same-day administration of the RSV vaccine and other adult vaccines, including the COVID-19 vaccine.

Eligible adults can get an RSV vaccine at any time, but the best time to vaccinate patients is in late summer and early fall before RSV usually starts to spread in the community.