Respiratory Syncytial Virus (RSV) Vaccine

There are 3 RSV vaccines:

• Nonadjuvanted RSV vaccine produced by Pfizer

• Adjuvanted RSV vaccine produced by GlaxoSmithKline

• Unadjuvanted mRNA-based RSV vaccine produced by Moderna

The Pfizer and GlaxoSmithKline RSV vaccines are inactivated recombinant respiratory syncytial virus glycoprotein antigen components. The Moderna RSV vaccine is a nucleoside modified mRNA encoding the RSV F glycoprotein (pre-F protein).

One of the currently available RSV vaccines (Pfizer) is indicated for pregnant women at 32 to 36 weeks gestation from September through January in most of the continental United States. In locations with RSV seasonality that differs from most of the continental United States (eg, Alaska, locations with tropical climate) follow guidance from public health authorities (eg, CDC, state and local health departments) or regional medical centers on timing of administration based on local RSV seasonality. The vaccine should be administered regardless of previous RSV infection.

The RSV vaccines (Pfizer, GlaxoSmithKline, or Moderna) are indicated for all adults ≥ 75 years and some adults ≥ 60 years, based on shared clinical decision-making. Specifically, adults ≥ 60 years who are most likely to benefit from vaccine are those considered to be at increased risk for severe RSV disease, including those with chronic medical conditions such as

• Lung diseases

• Cardiovascular diseases

• Neurologic or neuromuscular conditions

• Kidney disorders

• Liver disorders

• Hematologic disorders

• Diabetes mellitus

• Moderate or severe immune compromise (either attributable to a medical condition or receipt of immunosuppressive medications or treatment)

People who are frail, of advanced age, or who reside in nursing homes or other long-term care facilities are also at high risk of severe RSV infection.

Contraindication for RSV vaccines is

• A severe allergic reaction (eg, anaphylaxis) to a vaccine component

The main precaution with RSV vaccines is

• Moderate or severe acute illness with or without fever

Respiratory syncytial virus vaccines are given as a single dose (0.5 mL) as an intramuscular injection.

Adverse effects include injection site pain, fatigue, myalgia, headache, and arthralgia.

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

1. Advisory Committee on Immunization Practices (ACIP): RSV Advisory Committee on Immunization Practices Vaccine Recommendations

2. Centers for Disease Control and Prevention (CDC): Respiratory Syncytial Virus (RSV) Immunizations

3. CDC: Healthcare Providers: RSV Vaccination for Adults 60 Years of Age and Over

4. CDC: Healthcare Providers: RSV Vaccination for Pregnant People

5. CDC: Healthcare Providers: RSV Prevention Information: RSV Immunization for Infants and Young Children