RSV Vaccines for Older Adults: Current Options & Guidance (2024 Update)

As of 2024, two RSV vaccines are FDA-approved and CDC-recommended for adults ≥60: Arexvy (GSK) and Abrysvo (Pfizer). Both are protein subunit vaccines (prefusion F).

RSV Burden in Older Adults

• ~60,000–160,000 hospitalizations, 6,000–10,000 deaths annually in US adults ≥65.
• High risk: cardiopulmonary disease, immunocompromise, frailty, nursing home residents.

Vaccine Profiles

	Arexvy	Abrysvo
Adjuvant	AS01E	None (unadjuvanted)
Efficacy (LRTD)	82.6% (1st season)	66.7% (1st season)
Duration	Data through 2 seasons	Data through 2 seasons
Co-administration	Flu, COVID OK	Flu, COVID OK

CDC Recommendation (Shared Clinical Decision-Making)

Adults ≥60 may receive a single dose after discussion with provider. No preferential recommendation. Prioritize those with chronic heart/lung disease, immunocompromise, or living in congregate settings.

Other Prevention

• Nirsevimab (monoclonal antibody) for infants <8 months.
• Maternal Abrysvo (32–36 weeks) protects infants 0–6 months.
• Hygiene: handwashing, masking when sick, avoiding ill contacts.

Side Effects

Injection site pain, fatigue, myalgia, headache (mostly mild-moderate). Rare: atrial fibrillation (0.1% Arexvy), GBS (monitoring ongoing).

Future

mRNA RSV vaccines (Moderna) in late-stage trials; pediatric vaccines advancing.

Ask your clinician about RSV vaccination at your next visit—ideally before fall respiratory season.