RSV Vaccination Recommendations for Adults

Current Recommendations by Age and Risk

• The Advisory Committee on Immunization Practices (ACIP) recommends a single dose of RSV vaccine for all adults aged ≥75 years and for adults aged 60–74 years who are at increased risk for severe RSV disease 1, 2, 3
• A single dose of any FDA-approved RSV vaccine is recommended for all adults ≥75 years, regardless of health status 1, 2
• Adults 60-74 years with increased risk factors for severe RSV disease should receive a single dose of RSV vaccine, with risk factors including chronic medical conditions, moderate or severe immunocompromise, residence in a nursing home or long-term care facility, and severe obesity 1, 2, 3, 4

Administration Guidelines

• Only a single lifetime dose of RSV vaccine is recommended, and adults who have previously received an RSV vaccine should not receive another dose 1, 2
• The RSV vaccine can be co-administered with seasonal influenza vaccine at different injection sites, and is preferably administered between September and November, before or early in the RSV season 5, 6

Evidence Supporting Recommendations

• Estimated RSV-associated hospitalizations, intensive care unit admissions, and deaths preventable over two consecutive RSV seasons per 1 million RSV vaccine doses administered exceed estimated numbers of potential vaccine-attributable Guillain-Barré syndrome cases 1, 4

Country-Specific Variations

• France recommends seasonal RSV vaccination for people aged ≥75 years and people aged ≥65 years with chronic respiratory or cardiac disease 7
• Ireland recommends RSV vaccination in all adults aged ≥65 years 7
• Italy recommends vaccination for all subjects aged ≥75 years and in subjects aged ≥60 years with chronic conditions 7

Important Clinical Considerations

• Patient attestation is sufficient evidence of the presence of a risk factor, and extensive medical documentation should not be required 1, 6
• Patients with inflammatory bowel disease who are 60 years of age and older should receive an RSV vaccine due to their 30% higher risk of hospitalization due to RSV compared with non-IBD control subjects 10

Pitfalls to Avoid

• Do not administer multiple doses of RSV vaccine - only a single lifetime dose is recommended 1, 2
• Do not delay vaccination for adults ≥75 years while waiting for medical documentation of risk factors - age alone is sufficient indication 1, 4