Who is rsv vaccine recommended for

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Last updated: April 8, 2026

Quick Answer: The RSV vaccine is primarily recommended for adults aged 60 and older, pregnant individuals at 32-36 weeks gestation, and infants under 8 months old entering their first RSV season. In 2023, the CDC approved two vaccines for older adults (Arexvy and Abrysvo) and a maternal vaccine (Abrysvo) to protect newborns. For infants, nirsevimab (Beyfortus) is recommended as a monoclonal antibody rather than a traditional vaccine.

Key Facts

Adults aged 60+ should discuss RSV vaccination with healthcare providers, with Arexvy showing 82.6% efficacy against lower respiratory tract disease in clinical trials
Pregnant individuals should receive Abrysvo at 32-36 weeks gestation during RSV season (typically September-January in the U.S.)
Infants under 8 months old entering their first RSV season should receive nirsevimab, which reduces RSV hospitalizations by 75%
High-risk children aged 8-19 months entering their second RSV season may receive nirsevimab if they have conditions like chronic lung disease
The CDC's Advisory Committee on Immunization Practices made these recommendations in 2023 based on clinical trial data involving over 34,000 participants

Overview

Respiratory syncytial virus (RSV) is a common respiratory pathogen that causes seasonal epidemics, typically peaking in winter months. For decades, RSV posed significant health risks to vulnerable populations without specific preventive options beyond supportive care. The virus causes approximately 58,000-80,000 hospitalizations annually in children under 5 years and 60,000-160,000 hospitalizations in adults 65 and older in the United States alone.

In 2023, a breakthrough occurred with the approval of the first RSV vaccines after decades of research. The U.S. Food and Drug Administration (FDA) approved two vaccines for older adults (Arexvy and Abrysvo) and one for pregnant individuals (Abrysvo). Additionally, nirsevimab (Beyfortus), a monoclonal antibody product, received approval for infant protection. These developments marked a turning point in RSV prevention following the 1960s failed vaccine trial that actually worsened disease in vaccinated children.

How It Works

RSV prevention strategies vary by population, utilizing both traditional vaccines and monoclonal antibodies.

Vaccines for Older Adults: Arexvy and Abrysvo are protein-based vaccines containing the RSV F (fusion) glycoprotein in its prefusion conformation. This stimulates antibody production against the virus. In clinical trials involving over 34,000 participants, Arexvy demonstrated 82.6% efficacy against lower respiratory tract disease with two or more symptoms.
Maternal Vaccination: Pregnant individuals receive Abrysvo between 32-36 weeks gestation during RSV season. Antibodies transfer through the placenta to protect newborns during their first vulnerable months. Clinical trials showed 81.8% efficacy against severe RSV disease in infants up to 90 days old.
Infant Protection: Nirsevimab (Beyfortus) is a monoclonal antibody administered as a single intramuscular injection to infants. Unlike vaccines that stimulate immune response, it provides direct, ready-made antibodies. It reduces RSV hospitalizations by approximately 75% in clinical trials.
Seasonal Timing: RSV vaccination follows seasonal patterns, with recommendations to administer doses before RSV season typically begins (September-January in most U.S. regions). This timing ensures maximum protection during peak viral circulation periods.

Key Comparisons

Feature	Adult RSV Vaccines (Arexvy/Abrysvo)	Infant Protection (Nirsevimab)
Target Population	Adults 60+ years old	Infants <8 months entering first RSV season
Mechanism	Active immunization (stimulates immune response)	Passive immunization (provides ready antibodies)
Administration Timing	Single dose before RSV season	Single dose before or during RSV season
Efficacy Duration	At least 2 RSV seasons based on current data	Approximately 5 months (one RSV season)
Clinical Trial Efficacy	82.6% against lower respiratory tract disease (Arexvy)	74.5% against medically attended RSV infection

Why It Matters

Reducing Hospitalizations: RSV causes approximately 177,000 hospitalizations annually across all age groups in the U.S. Vaccination could prevent tens of thousands of these hospitalizations, particularly among infants and older adults who account for the majority of severe cases.
Economic Impact: RSV hospitalizations cost the U.S. healthcare system over $1.5 billion annually. Preventing these cases through vaccination represents significant potential savings while reducing strain on healthcare resources during winter months.
Vulnerable Population Protection: Before vaccine availability, RSV was the leading cause of hospitalization in infants under 1 year. Protection now extends to this vulnerable group through maternal vaccination and infant monoclonal antibodies.

The introduction of RSV vaccines represents a major advancement in respiratory virus prevention. As vaccination programs expand, ongoing surveillance will monitor effectiveness and safety in real-world settings. Future developments may include combination vaccines and broader age recommendations as more data becomes available. These preventive measures complement existing strategies like influenza and COVID-19 vaccination to create comprehensive respiratory protection for vulnerable populations.