RSV Vaccine Should Be Given as a Single Lifetime Dose, Not Annually
Adults who receive RSV vaccination should receive only one dose in their lifetime and should not be revaccinated annually or at any other interval. 1, 2
Current Dosing Recommendation
- A single lifetime dose of RSV vaccine is the current standard of care for all adults aged ≥60 years. 1, 2
- Adults who have previously received any RSV vaccine should not receive another dose, regardless of which vaccine product they received. 1, 2, 3
- This single-dose recommendation applies uniformly to all three FDA-approved RSV vaccines: Arexvy (GSK), Abrysvo (Pfizer), and mResvia (Moderna). 1, 2
Duration of Protection
- A single dose of RSV vaccine provides protection for at least two consecutive RSV seasons based on current clinical trial data. 2, 3
- RSVPreF3 (Arexvy) maintains efficacy for at least three seasons in adults aged ≥60 years. 2
- RSVpreF (Abrysvo) maintains efficacy for at least two seasons in adults aged ≥60 years. 2
- While vaccine efficacy decreases over time, it remains clinically meaningful compared to placebo even after multiple seasons. 4
Why Not Annual Vaccination?
The Advisory Committee on Immunization Practices (ACIP) explicitly states that there is no annual or periodic revaccination schedule for RSV vaccine in adults. 3 This differs fundamentally from influenza vaccination, which requires annual administration due to:
- Different viral characteristics and immune response patterns 2
- Longer duration of protection conferred by RSV vaccines compared to influenza vaccines 2
- Ongoing evaluation of whether additional doses will ever be needed 2, 3
Future Considerations
- ACIP will evaluate the need for additional RSV vaccine doses in the future as more data on duration of protection and immune response after revaccination become available. 2, 3
- Recommendations may be updated if evidence emerges showing waning immunity beyond two seasons that results in clinically significant breakthrough infections. 2, 3
- Until such data emerge and recommendations change, no revaccination should occur for at least two full RSV seasons. 2
Optimal Timing for the Single Dose
- Eligible adults who have not previously received RSV vaccination may be vaccinated at any time of year. 2, 3
- Vaccination provides the most benefit when administered in late summer or early fall (August-October in most of the continental United States), just before RSV season begins. 2, 3
- The vaccine should preferably be administered between September and November to maximize protection during peak transmission months. 1, 2
Clinical Implementation Pitfall to Avoid
Do not treat RSV vaccination like influenza vaccination. The most common error in clinical practice is assuming RSV vaccines require annual administration because they prevent a respiratory virus. 2, 3 This is incorrect and could lead to unnecessary revaccination, which is not currently recommended and for which safety and efficacy data do not exist. 2, 3