Is Respiratory Syncytial Virus (RSV) vaccine a one-time vaccination or does it require repeat vaccinations?

RSV Vaccination: One-Time Dose with No Current Recommendation for Repeat

According to the most recent 2024 Advisory Committee on Immunization Practices (ACIP) guidelines, eligible adults should receive a single dose of RSV vaccine; adults who have already received RSV vaccination should not receive another dose. 1

Current Recommendations for RSV Vaccination

The current guidance is clear about the dosing schedule for RSV vaccines:

• A single dose provides protection for at least two RSV seasons 1
• Adults who have already received RSV vaccination should not receive another dose 1
• The need for additional RSV vaccine doses will be evaluated by ACIP in the future, with recommendations updated as needed 1

Who Should Receive RSV Vaccination

The 2024 ACIP recommendations specify that:

• All adults aged ≥75 years should receive a single dose of RSV vaccine 1, 2
• Adults aged 60-74 years who are at increased risk for severe RSV disease should receive a single dose of RSV vaccine 1, 2
• High-risk conditions include:
  • Chronic respiratory diseases, particularly COPD and emphysema 3
  • Chronic cardiovascular disease 3
  • Immunocompromising conditions 3
  • Frailty 1

Timing of Vaccination

• Eligible adults may be vaccinated at any time of year 1
• Vaccination will have the most benefit if administered in late summer or early fall, just before the RSV season (August-October in most of the continental United States) 1

Available RSV Vaccines

Currently, two RSV vaccines are available in many countries:

1. RSVPreF3 (Arexvy): Contains recombinant RSV pre-fusion F protein adjuvanted with AS01E 1
2. RSVpreF (Abrysvo): Contains recombinant bivalent RSV-A and RSV-B pre-fusion F protein 1

Both vaccines are administered as a single intramuscular injection 1.

Duration of Protection and Future Considerations

• Current data shows protection for at least two RSV seasons with a single dose 1, 3
• The ACIP has explicitly stated that they will evaluate the need for additional RSV vaccine doses in the future 1
• As of 2024, the recommendation remains that adults who have already received RSV vaccination should not receive another dose 1

Special Considerations

• RSV vaccines can be safely co-administered with other adult vaccines, including influenza vaccines 1, 3
• Current vaccination coverage remains suboptimal, with only 39.7% of adults aged ≥75 years and 31.6% of adults aged 60-74 years at increased risk having received an RSV vaccine 2

Pitfalls to Avoid

• Do not administer unnecessary revaccination, as current guidelines specifically recommend against it 1
• Do not confuse adult RSV vaccination with palivizumab (Synagis), which is used for RSV prevention in high-risk infants and children, not adults 4
• Do not miss the opportunity to vaccinate eligible adults, as RSV can cause significant morbidity and mortality in older populations 3

The evidence clearly indicates that RSV vaccination is currently recommended as a single lifetime dose, with no recommendation for revaccination at this time. The ACIP will continue to evaluate the need for additional doses as more data becomes available on duration of protection.