RSV MAY RAISE THE STAKES FOR OLDER ADULTS

Respiratory syncytial virus (RSV) is a common and contagious virus that typically produces mild, cold-like symptoms but can put older adults at risk for severe outcomes.1,2*

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*The CDC states that adults at highest risk for severe RSV infection include older adults, especially those 75 years and older, adults with chronic heart or lung disease, and adults with weakened immune systems.1

THE CDC RECOMMENDS:

  • Adults 75 years of age and older receive a single dose of RSV vaccine3
  • Adults 50-74 years of age who are at increased risk of severe RSV disease receive a single dose of RSV vaccine3

ADDITIONAL INFORMATION FROM THE CDC

Eligible adults are currently recommended to receive a single dose of RSV vaccine; adults who have already received RSV vaccination should not receive another dose. Eligible adults may be vaccinated at any time of year, but vaccination will have the most benefit if administered in late summer or early fall, just before the RSV season.3,4

List of CDC-Identified Risk Factors for Severe RSV Disease3

  • See the List

    Qualified vaccinators, including pharmacists, nurse practitioners, and other providers (based on state and jurisdictional law) may determine patient eligibility for RSV vaccination based on clinical assessment even in the absence of medical documentation of a named risk condition. Patient attestation is sufficient evidence of the presence of a risk factor; vaccinators should not deny RSV vaccination to a person because of lack of documentation.3,4

    • Chronic cardiovascular disease (eg, heart failure, coronary artery disease, or congenital heart disease [excluding isolated hypertension])
    • Chronic lung or respiratory disease (eg, chronic obstructive pulmonary disease, emphysema, asthma, interstitial lung disease, or cystic fibrosis)
    • End-stage renal disease or dependence on hemodialysis or other renal replacement therapy
    • Diabetes mellitus complicated by chronic kidney disease, neuropathy, retinopathy, or other end-organ damage, or requiring treatment with insulin or sodium-glucose cotransporter-2 (SGLT2) inhibitor
    • Neurologic or neuromuscular conditions causing impaired airway clearance or respiratory muscle weakness (eg, poststroke dysphagia, amyotrophic lateral sclerosis, or muscular dystrophy [excluding history of stroke without impaired airway clearance])
    • Chronic liver disease (eg, cirrhosis)
    • Chronic hematologic conditions (eg, sickle cell disease or thalassemia)
    • Severe obesity (body mass index ≥40 kg/m2)
    • Moderate or severe immune compromise
    • Residence in a nursing home
    • Other chronic medical conditions or risk factors that a healthcare provider determines would increase the risk for severe disease due to viral respiratory infection (eg, frailty,* situations in which healthcare providers have concern for presence of undiagnosed chronic medical conditions, or residence in a remote or rural community where transportation of patients with severe RSV disease for escalation of medical care is challenging†)

    *Frailty is a multidimensional geriatric syndrome that reflects a state of increased vulnerability to adverse health outcomes. Although no consensus definition exists, one frequently used tool for determination is the Fried frailty phenotype assessment in which frailty is defined as a clinical syndrome with 3 or more of the following symptoms present: unintentional weight loss (10 lbs [4.5 kg] in the past year), self-reported exhaustion, weakness (grip strength), slow walking speed, or low physical activity.

    †Healthcare providers caring for adults aged 60-74 years residing in these communities may use clinical judgment, knowledge of local RSV epidemiology, and community incidence of RSV-associated hospitalization to recommend vaccination for a broader population in this age group.

CDC=Centers for Disease Control and Prevention; CHF=congestive heart failure; COPD=chronic obstructive pulmonary disease.

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Tumbling Jenga blocks

*The CDC states that adults at highest risk for severe RSV infection include older adults, especially those 75 years and older, adults with chronic heart or lung disease, and adults with weakened immune systems.1 

THE CDC RECOMMENDS:

  • Adults 75 years of age and older receive a single dose of RSV vaccine3
  • Adults 50-74 years of age who are at increased risk of severe RSV disease receive a single dose of RSV vaccine3

ADDITIONAL INFORMATION FROM THE CDC

Eligible adults are currently recommended to receive a single dose of RSV vaccine; adults who have already received RSV vaccination should not receive another dose. Eligible adults may be vaccinated at any time of year, but vaccination will have the most benefit if administered in late summer or early fall, just before the RSV season.3,4

List of CDC-Identified Risk Factors for Severe RSV Disease3

  • See the List

    Qualified vaccinators, including pharmacists, nurse practitioners, and other providers (based on state and jurisdictional law) may determine patient eligibility for RSV vaccination based on clinical assessment even in the absence of medical documentation of a named risk condition. Patient attestation is sufficient evidence of the presence of a risk factor; vaccinators should not deny RSV vaccination to a person because of lack of documentation.3,4

    • Chronic cardiovascular disease (eg, heart failure, coronary artery disease, or congenital heart disease [excluding isolated hypertension])
    • Chronic lung or respiratory disease (eg, chronic obstructive pulmonary disease, emphysema, asthma, interstitial lung disease, or cystic fibrosis)
    • End-stage renal disease or dependence on hemodialysis or other renal replacement therapy
    • Diabetes mellitus complicated by chronic kidney disease, neuropathy, retinopathy, or other end-organ damage, or requiring treatment with insulin or sodium-glucose cotransporter-2 (SGLT2) inhibitor
    • Neurologic or neuromuscular conditions causing impaired airway clearance or respiratory muscle weakness (eg, poststroke dysphagia, amyotrophic lateral sclerosis, or muscular dystrophy [excluding history of stroke without impaired airway clearance])
    • Chronic liver disease (eg, cirrhosis)
    • Chronic hematologic conditions (eg, sickle cell disease or thalassemia)
    • Severe obesity (body mass index ≥40 kg/m2)
    • Moderate or severe immune compromise
    • Residence in a nursing home
    • Other chronic medical conditions or risk factors that a healthcare provider determines would increase the risk for severe disease due to viral respiratory infection (eg, frailty,* situations in which healthcare providers have concern for presence of undiagnosed chronic medical conditions, or residence in a remote or rural community where transportation of patients with severe RSV disease for escalation of medical care is challenging†)

    *Frailty is a multidimensional geriatric syndrome that reflects a state of increased vulnerability to adverse health outcomes. Although no consensus definition exists, one frequently used tool for determination is the Fried frailty phenotype assessment in which frailty is defined as a clinical syndrome with 3 or more of the following symptoms present: unintentional weight loss (10 lbs [4.5 kg] in the past year), self-reported exhaustion, weakness (grip strength), slow walking speed, or low physical activity.

    †Healthcare providers caring for adults aged 60-74 years residing in these communities may use clinical judgment, knowledge of local RSV epidemiology, and community incidence of RSV-associated hospitalization to recommend vaccination for a broader population in this age group.

CDC=Centers for Disease Control and Prevention; CHF=congestive heart failure; COPD=chronic obstructive pulmonary disease.

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References:

1. Respiratory syncytial virus infection (RSV). RSV in adults. Centers for Disease Control and Prevention. Accessed July 9, 2025. https://www.cdc.gov/rsv/adults/index.html 2. Mesa-Frias M, Rossi C, Emond B, et al. Incidence and economic burden of respiratory syncytial virus among adults in the United States: a retrospective analysis using 2 insurance claims databases. J Manag Care Spec Pharm. 2022;28(7):753-765. doi:10.18553/jmcp.2022.21459 3. Respiratory syncytial virus infection (RSV). RSV vaccine guidance for adults. Centers for Disease Control and Prevention. Accessed July 10, 2025. https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/adults.html 4. Britton A, Roper LE, Kotton CN, et al. Use of respiratory syncytial virus vaccines in adults aged ≥60 years: updated recommendations of the Advisory Committee on Immunization Practices — United States, 2024. MMWR. 2024;73(32):696-702. doi:10.15585/mmwr.mm7332e1