Current RSV Vaccine Recommendations for Adults Over 65
Recent updates from the Centers for Disease Control and Prevention (CDC) indicate that adults over 65 are recommended to receive a single dose of an FDA-licensed RSV vaccine. This differs from annual vaccinations like the flu shot, as repeat vaccinations are not currently recommended each RSV season. The CDC's Advisory Committee on Immunization Practices (ACIP) recommends a single dose for all adults aged 75 and older. For those aged 60 to 74, the recommendation is based on shared clinical decision-making with a healthcare provider, especially for individuals with risk factors for severe RSV disease.
Who Needs an RSV Shot After 65?
For adults aged 60 and above, RSV can lead to severe lower respiratory tract disease (LRTD) and hospitalization. Key groups recommended for the RSV vaccine include:
- All adults ages 75 and older: One dose is recommended.
- Adults ages 60-74 with underlying risk factors: Vaccination is recommended based on shared clinical decision-making for those at increased risk of severe RSV. Risk factors include chronic conditions (COPD, asthma, heart failure, diabetes), moderate or severe immune compromise, and residence in long-term care facilities.
Comparison: RSV Vaccine vs. Flu Shot Frequency
The RSV vaccine differs from the annual flu shot in frequency due to variations in virus evolution and duration of immunity.
| Feature | RSV Vaccine (for Adults 65+) | Flu Shot |
|---|---|---|
| Frequency | Currently a single dose. | Annually. |
| Reason for Frequency | Protects for at least two RSV seasons. Monitoring continues for potential revaccination needs. | Influenza virus mutates frequently, requiring a new vaccine each year. |
| Type of Protection | Offers sustained, multi-season immunity based on clinical data. | Targets seasonal influenza strains. |
| Eligibility | All adults 75+ and those 60-74 with increased risk. | Recommended for almost everyone 6 months and older. |
| Timing | Administered before the fall/winter RSV season, typically late summer/early fall. | Best to receive in September or October. |
Why Only One Dose Is Recommended for Now
The recommendation for a single dose in older adults is based on clinical trial data showing durable protection for at least two RSV seasons with vaccines like Arexvy and Abrysvo. Studies, such as one in The Lancet, have shown high effectiveness (around 80%) against severe disease, hospitalization, and death in older adults, including those with immunocompromising conditions. The long-lasting immunity contrasts with the annual mutation of the flu virus, eliminating the need for a yearly RSV shot at this time. The CDC and FDA are monitoring long-term protection, and recommendations may be updated as more data becomes available.
How to Decide if You Need the RSV Shot
For adults aged 60 to 74 with risk factors, the decision to get vaccinated involves shared clinical decision-making with a healthcare provider. This discussion considers the individual's health risks, preferences, and vaccine characteristics. Providers can assess risk based on chronic conditions, age, frailty, and living situation. Individuals with conditions like COPD or congestive heart failure are strong candidates.
Co-administration with Other Vaccines
Co-administration of the RSV vaccine with other adult vaccines, such as flu or COVID-19 shots, is safe. However, combining vaccines may increase the likelihood of common side effects like fever or injection site pain. Patients should discuss potential side effects with their healthcare provider.
Conclusion
The current recommendation for adults over 65 is a single dose of the RSV vaccine, not an annual shot. All adults 75 and older are recommended for vaccination, while those 60-74 with risk factors should consult their provider. Clinical data indicates at least two seasons of protection, with ongoing monitoring to inform future guidance. Given the vaccine's effectiveness against severe illness, older adults should discuss eligibility with a healthcare professional. Learn more from the CDC here: CDC RSV Vaccine Guidance for Adults.
