Before delving into the RSV vaccine, let’s clarify what RSV is—and what it isn’t.

RSV (respiratory syncytial virus) is a common virus of the upper respiratory tract that causes mild, cold- and flu-like symptoms, such as nasal congestion and a sore throat. It is a hardy, highly contagious pathogen that is spread through the air and on hard surfaces. An infected individual can continue to spread the disease for up to a month after recovery!

Many think of RSV as primarily a childhood disease. Although it is the leading cause of infant hospitalization, older populations are also vulnerable. In fact, those over age 74 face the highest risk of RSV-associated deaths, and certain underlying conditions place seniors at an enhanced risk of RSV-related respiratory failure and hospitalization. High-risk conditions include immune and neurologic diseases, diabetes, severe obesity and nursing home residency. Chronic disorders of the liver, blood, kidney, heart and lungs also fit the high-risk definition. In vulnerable individuals, a run-of-the-mill RSV “cold” can suddenly invade the lower respiratory tract as unchecked inflammation and multiplying viruses travel down the windpipe into the lungs. Severe blockage of the airways is then triggered, leading to hospitalization, vital organ complications and a diminished quality of life.

When compared with the flu, RSV causes longer hospital stays, higher ICU admission rates and more pneumonia. Unlike the flu, there are no adult-approved anti-RSV medications. It is believed that the incidence of RSV is vastly underestimated, as most outpatient lower respiratory tract illnesses are not identified.

Bluntly stated, RSV is best managed through prevention. The vaccines prevent the virus from penetrating the lower respiratory tract and causing pneumonia, which can be severe in at-risk populations.

RSV vaccines just became available in 2023, and guidelines will continue to evolve as more people become educated and opt in. The three FDA-approved RSV vaccines are all egg-free: Abrysvo, Arexvy and the messenger RNA option, mRESVIA. Side effects include headache, fatigue, and muscle pain.

Both influenza and RSV viruses follow a seasonal pattern of fall through spring, and vaccinations for both are encouraged. Although the Centers for Disease Control has approved both flu and RSV vaccines for safe and effective co-administration in late summer/early fall, temporary post-vaccine aches and fatigue may intensify when taken together. If administered separately, no waiting period is required between vaccines.

In 2025, RSV vaccination advice was updated to recommend a single lifetime dose for high-risk candidates ages 50–74 years, and vaccination for all adults 75 and older. It is covered at no cost for qualified recipients under Medicare Part D and by most commercial insurance plans. Currently, all three RSV vaccines are equally recommended. Although no RSV vaccine can guarantee you will not get RSV, immunization offers the best chance at avoiding hospitalization. As always, check with your healthcare provider for individualized vaccine guidance.

Judi Shor is a board-certified senior care manager with advanced expertise in geriatric medication therapy. She operates a senior care management practice in the Coachella Valley and can be reached at (760) 271.2284 or www.ShorCareSuccessfulAging.com

Sources: 1) Ambrosch A, et al. Focusing on severe infections with the respiratory syncytial virus (RSV) in adults: Risk factors, symptomatology and clinical course compared to influenza A / B and the original SARS-CoV-2 strain. J Clin Virol. 2023 Apr;161:105399. doi: 10.1016/j.jcv.2023.105399. Epub 2023 Feb 14. Erratum in: J Clin Virol. 2023 Jul;164:105443. doi: 10.1016/j.jcv.2023.105443. PMID: 36863135; PMCID: PMC9927795; 2) Perez KK, et al. Outpatient RSV Testing Rates Among US Adults with Lower Respiratory Tract Disease, 2017-2024. Infect Dis Ther. 2026 Mar;15(3):809-834. doi: 10.1007/s40121-026-01300-z. Epub 2026 Jan 29. PMID: 41611956; PMCID: PMC12924803; 3) Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, “Respiratory Syncytial Virus (RSV),” updated September 5, 2025; 4) Britton, Amadea, et al. “Use of Respiratory Syncytial Virus Vaccines in Adults Aged ≥60 Years: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2024.” Morbidity and Mortality Weekly Report 73, no. 32 (August 15, 2024): 696–702. Centers for Disease Control and Prevention.5) https://www.cdc.gov/rsv/causes/index.html#content-sources