CDC Strengthens RSV Vaccine Recommendations for People 75 and Older

The Centers for Disease Control and Prevention (CDC) on Wednesday updated its recommendations for respiratory syncytial virus (RSV) vaccination for older adults who did not get vaccinated last season.

The agency now suggests that all adults older than 75 get the vaccine. People ages 60 to 74 who are at high risk for severe RSV are also recommended to get the shot. This includes people who have chronic conditions like lung or heart disease and those living in nursing homes.

After the approval of the first RSV vaccine last summer, the agency said that all adults ages 60 and older should get the vaccine if they speak with a healthcare provider and decide together that vaccination is right for them.

However, that guidance confused patients and complicated the administration of the vaccine. The CDC updated the recommendation to simplify the decision-making process for clinicians and the public.

“We believe this updated recommendation for people 60 and older provides healthcare providers with a clearer recommendation for those who will benefit most from RSV vaccine and will be easier to implement in healthcare settings,” a spokesperson for the CDC told Verywell in an email.

For most people, an RSV infection feels like a bad cold. However, older adults and infants are more likely to develop pneumonia and respiratory failure. Each year, RSV leads to an estimated 60,000 to 160,000 hospitalizations and more than 6,000 deaths in adults 65 years and older.

About a quarter of older Americans have had a dose of the RSV vaccine.

The RSV vaccine is not currently an annual vaccine, so older adults do not need to get a dose every RSV season, according to the CDC spokesperson. This means if you have already gotten an RSV vaccine, you do not need to get another one at this time.

The best time to get an RSV vaccine is in the late summer or early fall for protection during the colder months. Adults can also get their RSV shot at the same time as some other vaccines, like those for flu, COVID-19, and pneumonia.

What to Know About the RSV Vaccines

The RSV vaccines have only been available for a year. Wednesday’s meeting was the first time the advisory committee discussed real-world data on how well and safely the vaccines are working.

That data showed that people older than 75 have over twice the rate of RSV-associated hospitalization compared to adults ages 60–74 years. 

“Moving to a standard recommendation, as opposed to a shared decision, shows that we’ve now got more clear data on what are the benefits of this vaccine. We know that it reduces the risk significantly, particularly for folks 75 and older, of being hospitalized or dying from RSV illness,” Robert Hopkins, Jr., MD, medical director of the National Foundation for Infectious Diseases, told Verywell.

There are three vaccines approved to prevent RSV in older adults. GlaxoSmithKline’s Arexvy is FDA-approved to immunize people 60 years and older, as well as those 50 to 59 who are at an increased risk of lower respiratory tract disease from RSV. Abrysvo, made by Pfizer, can be given to adults ages 60 and older. It’s also approved for use in people who are 32 to 36 weeks pregnant to protect their babies in infancy.

Even though the GSK shot is authorized for people 50 to 59 years old, the CDC declined to recommend it for that group.

An RSV vaccine from Moderna, which gained FDA approval last month, will be given under the same guidance as the other vaccines.

The main safety concern associated with the vaccines is Guillain-Barré syndrome, a rare condition in which the immune system attacks the nerves. Based on the current data, the risk of someone developing Guillain-Barré from the vaccines is about 10 in a million.

The earlier shared clinical decision-making recommendation was made in part to help people weigh the benefits, risks, and costs of vaccination with help from their health provider.

However, a survey found that 76% of internal medicine physicians and 64% of family practitioners who responded either strongly or somewhat agreed that shared clinical decision-making “creates confusion.” Besides, about 80% of older adult vaccines were given in pharmacies, so it can be unnatural for a patient to work in a conversation with their physician before getting the shot.

Hopkins said the recommendations will likely change again as scientists collect more data about the side effects and duration of protection from vaccination.

Insurance Coverage for RSV Vaccination May Improve

While the goal is to vaccinate as many high-risk people as possible, Hopkins said the rollout is “pretty darn amazing” so far.

Under the Affordable Care Act, private insurers don’t have to cover a new vaccine that’s been on the market for less than a year. Now that GSK’s RSV vaccine has been approved for a year, there may be a lower barrier to accessing it.

The CDC also highlighted disparities in the demographics of older adults who have been vaccinated so far. Adults who are Hispanic, are uninsured, live in rural areas, and/or have a lower income have the lowest vaccination rates. CDC advisors said that clarifying the messaging about who would benefit most from vaccination could help remove barriers to access.

People ages 60 to 74 years old can still get the vaccine if they want it, but private insurers won’t be required to cover the cost, the CDC said.

Getting vaccinated against RSV is especially important for people at high risk for respiratory infections because there are no antiviral medications to help treat people who are sick with RSV.

“This is not an insignificant virus. It’s a virus that causes significant disease,” Hopkins said.