The RSV vaccine is recommended for pregnant women and older adults to protect infants and older adults against RSV respiratory infection, which can cause serious disease in these age groups.
For more information, see RSV Advisory Committee on Immunization Practices Vaccine Recommendations and Centers for Disease Control and Prevention (CDC): Respiratory Syncytial Virus (RSV) Immunizations. For a summary of changes to the 2024 adult immunization schedule, see the Advisory Committee on Immunization Practices (ACIP) Recommended Adult Immunization Schedule, United States, 2024.
(See also Overview of Immunization.)
Preparations of RSV Vaccine
There are two RSV vaccines:
Nonadjuvanted RSV vaccine produced by Pfizer
Adjuvanted RSV vaccine produced by GlaxoSmithKline
Both RSV vaccines are inactivated recombinant respiratory syncytial virus glycoprotein antigen components.
Indications for RSV Vaccine
The RSV vaccine (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 or GlaxoSmithKline) are indicated for adults age 60 years or older, based on shared clinical decision-making. Older adults 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.
Contraindications and Precautions for RSV Vaccine
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
Dose and Administration of RSV Vaccine
Respiratory syncytial virus vaccines are given as a single dose (0.5 mL) as an intramuscular injection.
Adverse Effects of RSV Vaccine
Adverse effects include injection site pain, fatigue, myalgia, headache, and arthralgia.
More Information
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
Advisory Committee on Immunization Practices (ACIP): RSV Advisory Committee on Immunization Practices Vaccine Recommendations
Centers for Disease Control and Prevention (CDC): Respiratory Syncytial Virus (RSV) Immunizations
CDC: Healthcare Providers: RSV Vaccination for Adults 60 Years of Age and Over
CDC: Healthcare Providers: RSV Vaccination for Pregnant People
CDC: Healthcare Providers: RSV Prevention Information: RSV Immunization for Infants and Young Children
