The Growing Threat of RSV to Older Adults
RSV is typically mild in young, healthy people, but it can be a serious threat to older adults, especially those with underlying health issues. As the immune system weakens with age, seniors find it harder to fight off infections, which can lead to severe lower respiratory tract disease (LRTD) like pneumonia or worsen conditions such as asthma, COPD, and congestive heart failure. Preventative measures, including vaccination, are therefore crucial for healthy aging.
What are the RSV vaccinations for seniors? The Available Options
As of 2025, three FDA-approved and CDC-recommended vaccines are available for older adults: Arexvy, Abrysvo, and mResvia. The CDC does not favor one vaccine over the others, allowing eligible adults to choose in consultation with their healthcare provider. Differences lie in their composition and specific indications. For the most current information, refer to the Centers for Disease Control and Prevention (CDC).
Arexvy (GSK)
- Mechanism: Arexvy is a recombinant protein subunit vaccine with an adjuvant to enhance immune response, which is helpful for older adults.
- Approval: Initially for adults 60 and older, its use was expanded in June 2024 to include adults 50-59 with certain risk factors for severe RSV.
- Composition: Contains a stabilized prefusion F protein from the RSV-A subtype.
Abrysvo (Pfizer)
- Mechanism: Abrysvo is a bivalent recombinant protein subunit vaccine, covering both RSV-A and RSV-B subgroups. It does not include an adjuvant.
- Approval: Approved for adults 60 and older, and also for those aged 18-59 with specific risk factors. It is also approved for pregnant individuals to protect newborns.
- Composition: Includes stabilized prefusion F proteins from both RSV-A and RSV-B subtypes.
mResvia (Moderna)
- Mechanism: This vaccine uses an mRNA platform, similar to some COVID-19 vaccines, instructing cells to produce an RSV protein to trigger an immune response.
- Approval: Licensed by the FDA in June 2024 for adults 60 years and older.
- Composition: A monovalent mRNA vaccine encoding the prefusion F glycoprotein.
Who Should Get Vaccinated? CDC Recommendations
The CDC, based on ACIP guidance, recommends a single dose of an RSV vaccine for specific adult populations:
- Adults aged 75 years and older.
- Adults aged 50–74 years who have an increased risk of severe RSV disease.
Understanding High-Risk Conditions
For those aged 50–74, conditions increasing the risk of severe RSV include chronic cardiovascular disease, chronic lung disease, diabetes with complications, chronic kidney or liver disease, weakened immune systems, severe obesity, and certain neuromuscular or neurologic conditions that affect breathing.
Comparing the RSV Vaccines for Seniors
Here is a table comparing the main features of the three RSV vaccines for seniors:
| Feature | Arexvy (GSK) | Abrysvo (Pfizer) | mResvia (Moderna) |
|---|---|---|---|
| Vaccine Type | Recombinant protein subunit, adjuvanted | Recombinant protein subunit, bivalent | mRNA |
| Approval | 60+; 50-59 with risk factors | 18+ with risk factors; 60+; maternal use | 60+ |
| Adjuvant | Yes | No | No (mRNA platform) |
| Bivalent | No (protects against both A/B strains) | Yes (contains both A/B antigens) | No (monovalent) |
| Real-World Efficacy | Approx. 83% against hospitalization (60+) | Approx. 73% against hospitalization (60+) | Efficacy data still emerging |
What to Expect: Side Effects and Safety
Common and temporary side effects for all three RSV vaccines include pain, swelling, or redness at the injection site, fatigue, headache, muscle pain, joint stiffness, nausea, and fever. While clinical trials and monitoring have shown a small, increased risk of Guillain-Barré Syndrome (GBS) after vaccination with Arexvy and Abrysvo, the FDA and CDC maintain that the benefits of preventing severe RSV significantly outweigh this rare risk for eligible adults. No GBS reports were found in mResvia trials, but monitoring continues. Discuss your health history with your doctor to evaluate your individual risks and benefits.
The Timing and Practicalities of Getting the Shot
When to get vaccinated? The CDC recommends getting the vaccine in the late summer or early fall (August-October in the continental U.S.), before the RSV season starts, although you can get it any time of year.
Is it an annual shot? The RSV vaccine is currently a one-time dose, not annual. Protection is expected to last at least two RSV seasons. The CDC and ACIP will continue to review data and may update recommendations on boosters in the future.
Can you get other vaccines at the same time? Yes, RSV vaccines can be given with other adult vaccines, like flu and COVID-19 shots. However, getting multiple vaccines at once might increase temporary side effects such as injection site pain or fatigue. Consult your healthcare provider for personalized advice.
Conclusion: Making an Informed Decision
With three effective options—Arexvy, Abrysvo, and mResvia—available, older adults have a key tool to protect against severe RSV. Understanding what are the RSV vaccinations for seniors?, their differences, and CDC guidance empowers individuals to talk to their healthcare provider. This discussion is vital to determine the most suitable vaccine for their health and ensure protection before the RSV season.
