RSV Vaccination Recommendations and Clinical Outcomes in Adults

Prevention Strategy

Vaccination is the most effective strategy for preventing RSV infection in adults, outweighing treatment options. (Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, 2024) 1

All adults aged ≥ 75 years should receive a single lifetime dose of an RSV vaccine, irrespective of comorbid conditions. (MMWR, 2024) 1
Adults aged 60–74 years should be vaccinated if they have any of the following risk factors: (MMWR, 2024) 1
- Chronic cardiovascular disease (e.g., heart failure, coronary artery disease)
- Chronic lung disease (e.g., COPD, asthma, interstitial lung disease)
- End‑stage renal disease or dependence on dialysis
- Diabetes with complications (requiring insulin or with end‑organ damage)
- Chronic liver disease (cirrhosis)
- Moderate or severe immunocompromise
- Severe obesity (BMI ≥ 40 kg/m²)
- Neurologic conditions that impair airway clearance
- Residence in a nursing home
Adults aged 50–59 years with any of the above risk factors should receive the RSVPreF3 (Arexvy) vaccine, the only formulation approved for this age group. (Praxis Medical Insights, 2026) 2

A single lifetime intramuscular dose is recommended; no booster doses are currently advised because protection extends for at least two RSV seasons. (Praxis Medical Insights, 2026) 2
Optimal administration timing is September through November, prior to the onset of the RSV season. (Praxis Medical Insights, 2026) 2
The RSV vaccine may be co‑administered with the seasonal influenza vaccine, provided each is given at a different injection site. (Praxis Medical Insights, 2026) 2

Elderly patients with pre‑existing cardiovascular disease require close monitoring for cardiac complications during RSV infection. (Praxis Medical Insights, 2026) 2
Acute cardiac events occur in approximately 22 % of hospitalized RSV patients overall and in 33 % of those with underlying cardiovascular disease. (Praxis Medical Insights, 2026) 2
Adults aged ≥ 75 years experience markedly poorer outcomes, with a 30‑day mortality hazard ratio of 2.85 compared with younger adults. (Praxis Medical Insights, 2026) 2

Do not withhold RSV vaccination from eligible patients due to missing documentation; a patient’s self‑reported risk factors are sufficient for eligibility. (MMWR, 2024) 1
Do not assume that a prior RSV infection confers lasting immunity; reinfection is common and does not contraindicate vaccination. (Praxis Medical Insights, 2026) 2