How often can you receive the Respiratory Syncytial Virus (RSV) vaccine?

RSV Vaccine Administration Frequency

The RSV vaccine is recommended as a single lifetime dose for adults aged 60 years and older, with no current recommendations for repeat or booster doses. 1

Recommendations for Different Age Groups

• Adults aged 60 years and older should receive a single dose of RSV vaccine, with priority given to those aged ≥75 years if vaccine supply is limited 2, 1
• Adults aged 50-59 years with risk factors for severe RSV disease should receive RSVPreF3 (the only vaccine approved for this age group) as a single dose 1, 3
• For adults with inflammatory bowel disease (IBD), those 60 years and older should receive a single dose of RSV vaccine, with no preference for any specific RSV vaccine 2

Timing of Vaccination

• Although the RSV vaccine can be administered at any time of year, it is preferably given between September and November, before or early in the RSV season 2, 1
• In the northern hemisphere, RSV season typically runs from November through April, though it may begin earlier or persist later in certain communities 2, 3

Duration of Protection

• In adults aged ≥60 years, the efficacy of RSVPreF3 has been maintained for at least three seasons 2, 3
• RSVpreF has demonstrated maintained efficacy for at least two seasons in adults aged ≥60 years 2, 3
• There are currently no recommendations for booster doses based on this extended protection 1

Special Considerations

• The RSV vaccine can be co-administered with seasonal influenza vaccines at different injection sites 2, 3
• For cancer patients, the effectiveness of RSV vaccines is unknown, and consultation with infectious disease specialists is recommended 2
• Previous RSV infection does not confer long-lasting immunity and does not contraindicate vaccination 1

Contrast with Pediatric RSV Protection

• Unlike the single-dose recommendation for adults, pediatric RSV protection follows a different protocol:
  • Palivizumab (Synagis) for high-risk infants is administered monthly throughout the RSV season 4
  • Nirsevimab (a long-acting monoclonal antibody) is approved for infants <24 months of age as a single dose 2, 5
  • Maternal RSVpreF vaccination during pregnancy (32-36 weeks' gestation) provides protection to infants through 6 months of age 3

Common Pitfalls to Avoid

• Do not confuse RSV vaccines with RSV monoclonal antibodies like palivizumab, which requires monthly administration throughout the RSV season 4
• Do not assume that RSV vaccination follows the same schedule as other adult vaccines like pneumococcal or influenza vaccines, which may require boosters or annual administration 2, 1
• Patient attestation is sufficient evidence of risk factors, and extensive medical documentation should not be required when determining eligibility 1

The burden of RSV in older adults has been historically underrecognized, accounting for significant hospitalizations for pneumonia and COPD exacerbations 1. The current recommendation of a single lifetime dose reflects our understanding of the extended protection provided by the available vaccines, though this guidance may evolve as more long-term data becomes available.