Currently Approved RSV Vaccines
Three RSV vaccines are currently FDA-approved and available in the United States: Arexvy (GSK), Abrysvo (Pfizer), and mResvia (Moderna). 1
Approved RSV Vaccines by Population
For Adults Aged ≥60 Years
All three vaccines are approved for prevention of RSV-associated lower respiratory tract disease in older adults:
- Arexvy (GSK) - Protein subunit vaccine containing stabilized prefusion F glycoproteins
- Abrysvo (Pfizer) - Bivalent protein subunit vaccine with prefusion F glycoproteins from RSV A and RSV B
- mResvia (Moderna) - mRNA vaccine (0.5 mL dose) containing nucleoside-modified mRNA encoding RSV F protein stabilized in prefusion conformation 1
Current ACIP recommendations (updated June 2024): A single dose is recommended for all adults aged ≥75 years and for adults aged 60-74 years who are at increased risk for severe RSV disease. Adults who have previously received any RSV vaccine should not receive another dose. 1
This represents an important update from the previous 2023 recommendation that used shared clinical decision-making, now providing clearer guidance on who should receive vaccination.
For Pregnant Persons (Maternal Immunization)
Abrysvo (Pfizer) is the only RSV vaccine approved for use during pregnancy 2
- Indication: Prevention of RSV-associated lower respiratory tract disease in infants aged <6 months through maternal antibody transfer
- Dosing: Single 0.5 mL intramuscular dose at 32-36 completed weeks' gestation (same formulation as used in older adults)
- Timing: Seasonal administration during September through January in most of the continental United States 2
Important safety consideration: FDA labeled a warning for potential risk of preterm birth, which is why administration is restricted to 32-36 weeks' gestation to avoid potential preterm birth at <32 weeks (which carries higher morbidity and mortality risk). More hypertensive disorders of pregnancy were observed in vaccine recipients versus placebo, though differences were not statistically significant. 2
Key Clinical Guidance Points
For infant protection: Either maternal RSVpreF vaccination during pregnancy OR nirsevimab (monoclonal antibody) administration to the infant is recommended, but both are not needed for most infants. All infants should receive protection through one of these products. 2
For adults who previously received RSV vaccine: Do not administer another dose - a single lifetime dose is currently recommended. 1
Vaccine interchangeability: While three products are approved for adults ≥60 years, there is no preference stated between them in current guidelines. 1