You’ll see changes to the respiratory syncytial virus (RSV) immunization recommendations in older adults...along with a new vaccine.
Last year, CDC said to use shared clinical decision-making to help adults ages 60 and older decide about RSV vaccination.
Now updated guidelines are more clear-cut...to simplify choices and prioritize patients at highest risk.
Recommend RSV vaccination for ALL patients ages 75 and older...plus those 60 to 74 with conditions that increase the risk of severe RSV.
For example, watch for patients who have heart, lung, or kidney disease...diabetes with organ damage (neuropathy, etc)...a BMI of 40 kg/m2 or more...or who are immunocompromised.
Explain that RSV vaccination is no longer recommended for patients 60 to 74 withOUT risk factors...they’re not as likely to benefit.
And point out that CDC does not yet recommend the RSV vaccine for those age 50 to 59...even though Arexvy is FDA-approved for these patients.
Give eligible patients 60 and up a single 0.5 mL IM dose of Abrysvo, Arexvy, or the first mRNA RSV vaccine, mRESVIA. Efficacy and side effects seem similar...and CDC has no preference for one product over another.
Be aware, FDA and CDC are investigating rare cases of Guillain-Barré syndrome after RSV vaccination. Benefits still outweigh potential risks.
Encourage immunization between Aug and Oct...for the most benefit.
If patients over 60 already got an RSV vaccine, don’t recommend another dose. Data suggest one dose offers protection for at least 2 years...and it’s too soon to say if or when revaccination will be needed.
Educate staff about RSV vaccine nuances...to limit errors.
For example, mRESVIA comes as prefilled syringes and does NOT require reconstitution...unlike Abrysvo or Arexvy.
Store Abrysvo or Arexvy in the fridge...but mRESVIA in the freezer.
Explain that mRESVIA must be thawed in the fridge or at room temp for 45 to 155 minutes before use...depending on the package size.
For walk-up or unscheduled RSV vaccines, rely on Abrysvo or Arexvy.
Find more product comparisons and other guidance in our resource, Preventing RSV...including recommendations for pregnant patients.
- CDC. Healthcare Providers: RSV Vaccination for Adults 60 Years of Age and Over. July 3, 2024. https://www.cdc.gov/vaccines/vpd/rsv/hcp/older-adults.html (Accessed July 25, 2024).
- Britton A, Melgar M, Roper L. Evidence to Recommendations Framework (EtR): RSV Vaccination in Adults Aged 50–59 years, 60–74 years, and 75 years and older. June 26, 2024. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2024-06-26-28/11-RSV-Adult-Melgar-Roper-Britton-508.pdf (Accessed July 25, 2024).
- Melgar M, Britton A. ACIP Adult RSV Work Group Clinical Considerations: Respiratory Syncytial Virus (RSV) in Adults 60 and older. June 26, 2024. https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2024-06-26-28/12-RSV-Adult-Melgar-508.pdf (Accessed July 25, 2024).
- Chart: Preventing RSV