- Overview of Immunization
- Chikungunya Vaccine
- COVID-19 Vaccine
- Diphtheria-Tetanus-Pertussis Vaccine
- Ebola Vaccine
- Haemophilus influenzae Type b (Hib) Vaccine
- Hepatitis A (HepA) Vaccine
- Hepatitis B (HepB) Vaccine
- Herpes Zoster Vaccine
- Human Papillomavirus (HPV) Vaccine
- Influenza Vaccine
- Measles, Mumps, and Rubella (MMR) Vaccine
- Meningococcal Vaccine
- Mpox Vaccine
- Pneumococcal Vaccine
- Poliomyelitis Vaccine
- Respiratory Syncytial Virus (RSV) Vaccine
- Rotavirus Vaccine
- Tetanus-Diphtheria Vaccine
- Varicella Vaccine
- Passive Immunization
The respiratory syncytial virus (RSV) vaccine is recommended for pregnant people to protect infants (1) and for older adults to protect against RSV infection (2), which can cause severe disease requiring hospitalization in these groups.
(See also Overview of Immunization.)
General references
1. Kampmann B, Madhi SA, Munjal I, et al. Bivalent Prefusion F Vaccine in Pregnancy to Prevent RSV Illness in Infants. N Engl J Med. 2023;388(16):1451-1464. doi:10.1056/NEJMoa2216480
2. Wilson E, Goswami J, Baqui AH, et al. Efficacy and Safety of an mRNA-Based RSV PreF Vaccine in Older Adults. N Engl J Med. 2023;389(24):2233-2244. doi:10.1056/NEJMoa2307079
Preparations of RSV Vaccine
There are 3 RSV vaccines:
Nonadjuvanted RSV vaccine
Adjuvanted RSV vaccine
Nonadjuvanted mRNA-based RSV vaccine
The nonadjuvanted RSV vaccine and the adjuvanted RSV vaccine are inactivated recombinant respiratory syncytial virus glycoprotein antigen components.
The nonadjuvanted mRNA-based RSV vaccine is a nucleoside-modified mRNA encoding the RSV F glycoprotein (preF protein).
Indications for RSV Vaccine
The nonadjuvanted RSV vaccine is indicated for pregnant patients at 32 through the end of 36 weeks gestation from September through January in most of the continental United States (1). Additional doses within the same or in subsequent pregnancies are not recommended. Infants born to pregnant patients who received RSV vaccine during a previous pregnancy should receive RSV monoclonal antibody instead. In locations with RSV seasonality that differs from most of the continental United States (eg, Alaska, locations with tropical climate), it is recommended that clinicians follow guidance from public health authorities (eg, the 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.
All 3 RSV vaccines are indicated for all adults ≥ 75 years and for 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 of severe RSV disease, including those with chronic medical conditions such as the following:
Lung diseases
Cardiovascular diseases
Neurologic or neuromuscular conditions
Kidney disorders
Liver disorders
Hematologic disorders
Diabetes mellitus
Moderate or severe immunocompromise (either attributable to a medical condition or to receipt of immunosuppressants or treatment)
People who are frail, ≥ 75 years, or who reside in nursing homes or other long-term care facilities are also at high risk of severe RSV infection.
Indications reference
1. Centers for Disease Control and Prevention. RSV Vaccine Guidance for Pregnant Women. Accessed April 18, 2025.
Contraindications and Precautions for RSV Vaccine
The main 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
The RSV vaccine is administered as a single 0.5 mL-dose IM.
Adverse Effects of RSV Vaccine
Adverse effects include injection site pain, fatigue, myalgia, headache, and arthralgia.
For more information about adverse effects of these vaccines, refer to the prescribing information.
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): ACIP Recommendations: Respiratory Syncytial Virus (RSV) Vaccine Immunizations
ACIP: Changes in the 2025 Child and Adolescent Immunization Schedule
Centers for Disease Control and Prevention (CDC): RSV (Respiratory Syncytial Virus)
CDC: Healthcare Providers: RSV Vaccination for Adults 60 Years of Age and Over
CDC: Healthcare Providers: RSV Immunization for Infants and Young Children
European Centre for Disease Prevention and Control (ECDC): RSV: Recommended vaccinations
