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Health Education

Everything you need to know about the RSV vaccine

Two FDA-approved RSV vaccines are available this season, but only certain groups are eligible
Leandra Beabout
By | Sep. 22, 2023 Medically reviewed by Karen Berger, Pharm.D.
syringe - rsv vaccine

Key takeaways

  • Two FDA-approved RSV vaccines, Arexvy and Abrysvo, are available for adults 60 years and older, with Abrysvo also approved for pregnant women between weeks 32 and 36 of pregnancy.

  • RSV (respiratory syncytial virus) is a common and highly contagious virus that can cause severe illness in young children, older adults, and those with weakened immune systems.

  • The FDA recently approved Beyfortus, a monoclonal antibody injection for infants and toddlers, providing short-term protection against RSV, but not a vaccine for pediatric use.

  • While the RSV vaccines are new, clinical trials indicate that Arexvy is 82.6% effective and Abrysvo is 88.9% effective at preventing symptomatic RSV, though their long-term effectiveness and annual necessity are still under study.

In this article:

“Tripledemic.” That’s the term floating around this season as healthcare providers gear up for the triple threat of flu, COVID-19, and RSV (respiratory syncytial virus). It’s that time of year when coworkers call in sick, throats get scratchy, and kids seem to develop chronic coughs and sniffles. 

We know that basic measures like drinking fluids and taking over-the-counter medications can help ease uncomfortable symptoms. But for some people, even common seasonal viruses pose a serious threat. This year, there are new vaccines to help at-risk populations ward off severe sickness, including that caused by RSV.

Here’s what you need to know about the new FDA-approved RSV vaccine.

What is RSV?

Respiratory syncytial virus, or RSV, is a common, highly contagious virus that affects the lungs. In most cases, RSV causes mild symptoms such as cough, runny nose, and fever. But young children, older adults, and individuals with weakened immune systems are at high risk of severe, potentially life-threatening RSV illness.

Because RSV is seasonal and very contagious, most children get it at some point before the age of 2. Most recover within a week or two, though they often pass the virus on to someone else in the household. RSV infection primarily spreads through airborne droplets when an infected person coughs or sneezes, but it can also spread through touch, such as when someone kisses a person with RSV or touches a surface contaminated with the virus and then touches their face. 

Infants under 12 months and adults older than 65 years are at highest risk of RSV complications, says Vanessa M. Tapia, DNP, APRN, a doctor of nursing and family nurse practitioner at Valley Oaks Medical Group in Las Vegas, Nevada. Infants have a high risk because their airways may be small enough to close up when inflamed and their immune systems aren’t yet fully developed. In older adults, the risk is heightened due to weakened immune systems and, in some cases, chronic lung or heart conditions. Those with lung disease, chronic obstructive pulmonary disease (COPD), congestive heart failure, or other underlying medical conditions can quickly develop severe respiratory illness requiring hospitalization.

Is there a vaccine for RSV?

This year, the U.S. Food and Drug Administration (FDA) approved two RSV vaccines for adults 60 years and older: Arexvy (RSVPreF3) and Abrysvo (RSVpreF), the latter of which was later also approved for pregnant individuals between weeks 32 and 36 of pregnancy. 

Not all vaccines work via the same science. The RSV vaccines are not mRNA immunizations, and “they are not live vaccines,” explains Blair Gingerich, Pharm.D., a clinical care and retail pharmacist in northern Indiana. That means there is no active respiratory syncytial virus in the dose. 

Both Arexvy and Abrysvo fall into the category of recombinant RSV protein antigen vaccines, another example of which is the egg-free flu shot, Flublok Quadrivalent. However, Gingerich emphasizes that the RSV shot is not the same as the flu shot—and vice versa. “Both [flu and RSV] vaccines are important and should not be considered substitutable for one another,” she says.

Is there an RSV vaccine for children?

The two FDA-approved RSV vaccines are not available for pediatric populations, but the FDA did recently approve the medication Beyfortus (nirsevimab-alip), a monoclonal antibody injection that can provide infants and toddlers with short-term protection against the virus. 

Monoclonal antibodies are not the same as vaccines, though. While vaccines actively train the immune system to protect against a specific virus such as RSV, antibody therapies support the immune system and reduce the chance of severe RSV for a limited time period, with immunity diminishing over time. 

Beyfortus is currently approved for infants born during or entering their first RSV season, and children up to 2 years of age going into their second RSV season. The single-dose injection can help provide protection against the virus during the RSV season. 

Who is eligible to get an RSV vaccine?

Two groups are currently eligible to get an RSV vaccine: adults 60 years and older and pregnant women in their third trimester, between weeks 32 and 36. In pregnant women, this vaccination prevents lower respiratory tract disease caused by RSV in infants when they are born, until they are 6 months old.

Eligibility criteria for vaccines tend to be based on who has the greatest risk of complications from a virus and who the drugs were tested on in clinical trials. When it comes to the RSV, that includes the oldest and youngest among us, so it makes sense that these are the groups who are eligible for the vaccine (the former group) and the monoclonal antibody drug (the latter group). 

“RSV is a common respiratory infection that affects people of all age groups,” Tapia says. “Healthy individuals can typically fight off infection on their own without the need for intervention.” In other words, most people don’t need extra protection against RSV because their bodies can handle the virus without medical treatment.

How effective are the RSV vaccines? 

The two RSV vaccines are new, but that doesn’t mean their effectiveness is untested. Both Arexvy and Abrysvo were tested on tens of thousands of study participants for at least one full RSV season, according to the Centers for Disease Control and Prevention (CDC).

In clinical trials, a single dose of Arexvy was found to be 82.6% effective at preventing symptomatic RSV. Abrysvo’s effectiveness was slightly higher, with one dose being 88.9% effective at preventing symptomatic RSV.

Both vaccines’ effectiveness diminished over time, but research is ongoing, so it is impossible to say exactly how long the immunity lasts and whether at-risk populations will need a new dose each year.

What are the side effects of the RSV vaccines?

Possible side effects of the RSV vaccines include:

  • Pain, redness, and/or swelling at the injection site
  • Fatigue
  • Muscle pain
  • Joint pain
  • Headache
  • Fever
  • Nausea
  • Diarrhea

Some people also experience lightheadedness or fainting during or after getting a vaccine injection. If you have an intense fear of needles or experience dizziness when you get shots, be sure to tell your pharmacist or medical provider at your RSV vaccine appointment.

Does insurance pay for the RSV vaccine?

In the past few years, many people have gotten used to receiving free COVID-19 shots from their local health departments or pharmacies, but that was in part due to the federal health emergency during which the government covered the costs. Now that the health emergency has ended, COVID-19 and other vaccines—including the RSV vaccine—may come with an out-of-pocket cost for certain individuals.

Tapia says the RSV vaccine will be covered for those who have Medicare Part D. Most patients with private insurance can likely expect to get the shot at no cost, per KFF Health News, but it’s not a sure thing. While the Affordable Care Act dictates that private insurers cover vaccines recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP), the language within the CDC’s RSV recommendation—stating it’s recommended for adults 60 and over “using shared clinical decision-making”—leaves some wiggle room for insurers based on healthcare providers’ individual recommendations. Tapia suggests checking with your insurance carrier about cost before heading to your appointment, so you’re prepared. 

If you are expected to pay out of pocket for the vaccine, you can use a SingleCare coupon to save on the cost. 

Should you get the RSV vaccine if you’re eligible? 

In general, the CDC recommends that anyone eligible for vaccination against RSV should go ahead and get the jab. However, it’s important to discuss your individual circumstances with a healthcare provider beforehand. 

If you decide to get the RSV vaccine, Tapia recommends taking a moment to read up on the basic safety information, which can be found on the Abrysvo and Arexvy websites.

And if you have yet to get your flu shot this year, Dr. Gingerich suggests there’s no need to schedule two appointments. “The CDC states the RSV vaccine may be administered at the same time as other vaccines,” she says.

Regardless of if you get the RSV vaccine, you can—and should—take steps to stay healthy during the upcoming cold and flu season. Wash your hands regularly, avoid close contact with people who have cold-like symptoms, and frequently clean high-touch surfaces like doorknobs and countertops.