RSV vaccines recommended for older and immunocompromised adults

The American College of Physicians recommends one RSV vaccine dose for adults 75 and older, and says adults 60–74 with certain health conditions may consider vaccination; the Infectious Diseases Society of America issued guidance supporting vaccination for many people with weakened immune systems.

The American College of Physicians and the Infectious Diseases Society of America published new guidance on respiratory syncytial virus (RSV) vaccination. The ACP recommends a single RSV vaccine dose for adults 75 and older and says adults ages 60–74 with medical conditions that raise their risk may consider vaccination. The IDSA focused its guidance on people with weakened immune systems and cited studies showing reduced hospitalizations. Recent CDC data show RSV was associated with large numbers of hospitalizations and deaths during July 2024–June 2025. Key points: - The ACP recommends one RSV vaccine dose for adults 75 and older; adults 60–74 with high-risk conditions may consider vaccination. - The ACP limited its recommendation to vaccines made with conventional technology and named Arexvy (GSK) and Abrysvo (Pfizer); it did not make a recommendation for Moderna’s mResvia because evidence was judged insufficient. - The IDSA issued a strong recommendation for age-appropriate RSV vaccination in many immunocompromised adults and noted two studies showing about a 70% reduction in RSV-associated hospitalization in this population; other older-adult data showed about 81% effectiveness at preventing critical illness. - CDC data cited in the guidance reported an estimated 190,000–350,000 hospitalizations and 10,000–23,000 deaths associated with RSV from July 1, 2024, to June 30, 2025. - The IDSA noted a small increased risk of Guillain-Barré syndrome, reporting about 11 additional cases per 1 million people vaccinated compared with unvaccinated people. - The American College of Obstetricians and Gynecologists recommends vaccination in pregnancy at about 32–36 weeks to help protect newborns, and the American Academy of Pediatrics generally recommends antibody injections for certain infants whose mothers were not vaccinated. Summary: The new society guidance focuses recommendations on adults at highest risk—older adults and people with weakened immune systems—and clarifies which vaccine technologies the ACP reviewed. The ACP currently recommends a single dose of conventional-technology RSV vaccines and did not recommend Moderna’s newer product because of limited evidence. Undetermined at this time.