RSV Vaccine Guidelines for Adults and Special Populations

Primary Age-Based Recommendations

The American College of Physicians recommends that all adults aged ≥75 years should receive a single lifetime dose of RSV vaccine regardless of comorbidities, due to significantly elevated rates of hospitalization, severe disease, and mortality in this population 1
Adults aged 60-74 years should receive RSV vaccination if they have any risk factors for severe RSV disease, as recommended by the American Academy of Family Physicians 1, 2
Adults aged 50-59 years with risk factors should receive RSVPreF3 (Arexvy), which is the only vaccine currently approved for this younger age group, according to the Centers for Disease Control and Prevention 1, 2

Chronic obstructive pulmonary disease (COPD) is a risk factor for severe RSV disease, as stated by the American Thoracic Society 1, 2
Asthma is a risk factor for severe RSV disease, as recommended by the American Academy of Allergy, Asthma, and Immunology 1, 2
Heart failure is a risk factor for severe RSV disease, as stated by the American Heart Association 1, 2
Diabetes mellitus is a risk factor for severe RSV disease, as recommended by the American Diabetes Association 1, 2

Arexvy (RSVPreF3) is a recombinant RSV pre-fusion F protein adjuvanted with AS01E, approved for adults ≥50 years, as stated by the Food and Drug Administration 1
Abrysvo (RSVpreF) is a recombinant bivalent RSV-A and RSV-B pre-fusion F protein, approved for adults ≥60 years, as recommended by the Centers for Disease Control and Prevention 1

A single lifetime dose of RSV vaccine is currently recommended, with no booster doses indicated at this time, as stated by the American College of Physicians 1, 2, 3
The vaccine should preferably be administered between September and November, before or early in the RSV season, to maximize protection during peak transmission months, as recommended by the Centers for Disease Control and Prevention 1, 2, 3

Cancer patients should consult with infectious disease specialists before receiving RSV vaccination, as recommended by the National Comprehensive Cancer Network 4
All adult patients with inflammatory bowel disease (IBD) aged ≥60 years should receive RSV vaccine, as stated by the American Gastroenterological Association 1
The long-acting RSV monoclonal antibody nirsevimab is approved for infants <24 months of age to prevent RSV infection, as recommended by the American Academy of Pediatrics 4, 5