What is the duration of protection provided by the Respiratory Syncytial Virus (RSV) vaccine?

Duration of RSV Vaccine Protection

The RSV vaccine provides protection for 2-3 seasons in adults aged ≥60 years, with efficacy maintained for at least three seasons for RSVPreF3 (Arexvy) and at least two seasons for RSVpreF (Abrysvo). 1

Adult RSV Vaccines

Duration of Protection

• For adults aged ≥60 years, the RSV vaccine offers multi-season protection:
  • RSVPreF3 (Arexvy) maintains efficacy for at least three RSV seasons 1
  • RSVpreF (Abrysvo) maintains efficacy for at least two RSV seasons 1
  • The cumulative efficacy over 3 seasons for RSVPreF3 is 62.9% 2

Timing of Vaccination

• While RSV vaccines can be administered at any time of year, optimal protection is achieved when vaccination occurs between September and November, just before the RSV season 1, 2
• This timing maximizes protection during peak RSV circulation, which typically occurs between November and March in the Northern Hemisphere 1

Pediatric RSV Protection

For infants and children at high risk for severe RSV disease, protection is provided through:

Palivizumab (Synagis)

• Palivizumab is administered as monthly injections during the RSV season 3
• Each dose provides approximately one month of protection 3
• For high-risk infants who qualify for prophylaxis, a typical regimen consists of 5 monthly doses 1
• When started in November, 5 monthly doses provide more than 20 weeks of protective serum antibody concentrations, covering most of the RSV season 1

Duration Considerations

• The RSV season typically lasts 15 weeks (median duration) in the United States, with regional variations 1
• Five monthly doses of palivizumab provide more than 6 months of serum concentrations above the protective threshold for most infants 1
• Palivizumab trough serum concentrations 30 days after the fifth dose remain well above the protective concentration for most infants 1

Important Clinical Considerations

Seasonal Timing

• RSV circulation varies by region:
  • In the Northern Hemisphere, RSV typically circulates between November and March 1
  • Southern U.S. communities experience earlier onset of RSV activity 1
  • Midwestern states tend to experience the latest onset 1
  • The national median duration of the RSV season is 15 weeks 1

Risk Factors for Severe Disease

• RSV vaccination is particularly important for:
  • Adults aged ≥75 years (all should receive vaccination) 2
  • Adults aged 60-74 years with risk factors such as chronic lung disease, heart failure, diabetes, chronic kidney disease, immunocompromised status, frailty, or nursing home residence 1, 2
  • High-risk infants, including those born prematurely or with chronic lung disease or congenital heart disease 1, 3

Vaccine Selection

• For adults ≥60 years, three FDA-approved options are available: Arexvy (GSK), Abrysvo (Pfizer), and mResvia (Moderna) 2
• For pregnant individuals between weeks 24-36 of gestation, RSVpreF (Abrysvo) can protect infants from birth through 6 months of age 1, 2

The evidence clearly shows that RSV vaccines provide significant protection spanning multiple seasons for adults, while pediatric protection through palivizumab requires monthly administration during the RSV season to maintain adequate protection.