RSV Vaccines Are NOT Live Vaccines
The currently approved RSV vaccines for adults are inactivated, recombinant protein subunit vaccines—not live-attenuated vaccines. 1
Currently Licensed RSV Vaccines
The RSV vaccines approved for use in adults aged ≥60 years (and RSVPreF3 for adults aged 50-59 years with risk factors) are recombinant protein subunit vaccines, similar in design to the recombinant zoster vaccine (RZV). 2, 1 These vaccines contain purified RSV fusion (F) protein antigens and are completely inactivated, meaning they contain no live viral particles. 1
Key Characteristics of Approved RSV Vaccines:
- Non-live formulation: These are recombinant subunit vaccines that cannot replicate in the human body 2
- Safe for immunocompromised patients: Unlike live vaccines, these can be administered to cancer patients and other immunocompromised individuals 2
- Can be co-administered with other inactivated vaccines: RSV vaccines may be given simultaneously with influenza, pneumococcal, or Tdap vaccines at different injection sites 1, 3
- No minimum interval required: When given on separate days from other inactivated vaccines, there is no mandatory waiting period 3
Important Distinction from Live-Attenuated RSV Vaccines
While live-attenuated RSV vaccines are in clinical development for potential pediatric use, none are currently licensed. 4, 5, 6 These investigational live vaccines would require different handling and have different contraindications than the currently approved adult vaccines. 6, 7, 8
Clinical Implications:
- The approved RSV vaccines can be safely administered to patients with cancer, those on immunosuppressive therapy, and elderly patients with multiple comorbidities 2, 1
- No special precautions regarding live vaccine administration (such as the 4-week spacing rule between live vaccines) apply to RSV vaccination 2, 3
- Healthcare providers should not confuse the investigational live-attenuated pediatric RSV vaccines under development with the currently licensed adult vaccines 4, 8