How often should an 80-year-old individual receive the Respiratory Syncytial Virus (RSV) vaccine?

RSV Vaccination for 80-Year-Old Adults: Single Dose Only

An 80-year-old individual should receive only one dose of RSV vaccine in their lifetime, with no revaccination recommended, as a single dose provides protection for multiple seasons. 1

Current Recommendations for Older Adults

The Advisory Committee on Immunization Practices (ACIP) has established clear guidelines regarding RSV vaccination for older adults:

• Adults aged ≥75 years (which includes 80-year-olds) should receive a single dose of any FDA-approved RSV vaccine (Arexvy, Abrysvo, or mResvia) 1, 2
• Adults who have previously received any RSV vaccine should not receive another dose 1
• The protection from a single dose extends across multiple RSV seasons (at least 2-3 years) 2

Evidence Supporting Single-Dose Strategy

The single-dose recommendation is based on strong clinical evidence:

• Clinical trials have demonstrated that vaccine efficacy persists across multiple seasons:

  • For RSVPreF3 (Arexvy), cumulative efficacy over 3 seasons against RSV-associated lower respiratory tract disease was 62.9% (97.5% CI: 46.7,74.8) 1
  • Efficacy remained at 48.0% (95% CI: 8.7,72.0) even in the third season 1

• In adults ≥80 years specifically, vaccine efficacy against RSV-associated lower respiratory tract disease was:

  • First season: 33.8% (95% CI: −477.7,94.5) 1
  • Second season: 41.0% (95% CI: −209.9,94.0) 1
  • Cumulative over two seasons: 38.4% (95% CI: −118.2,86.1) 1

Practical Implementation

When administering the RSV vaccine to an 80-year-old:

• Optimal timing: Before RSV season (August-October in most of continental US) 2
• Administration: Single 0.5 mL intramuscular injection 1
• Co-administration: Can be safely given with influenza vaccine 2
• Documentation: Important to document vaccination to prevent unnecessary revaccination 2

Common Pitfalls to Avoid

1. Mistaking RSV vaccination for annual vaccination: Unlike influenza vaccines, RSV vaccines are not administered annually. A single dose provides multi-season protection 1, 2

2. Revaccinating previously vaccinated individuals: The ACIP explicitly states that adults who have previously received an RSV vaccine should not receive another dose 1

3. Delaying vaccination: For maximum benefit, vaccination should occur before RSV season starts, typically between September and November in most regions 2

4. Overlooking eligibility: All adults aged ≥75 years should receive the RSV vaccine regardless of health status, as they are at high risk for severe RSV disease 1, 2

The evidence strongly supports that RSV vaccination is a one-time intervention for older adults, with no current recommendation for revaccination at any interval.