Know What’s New With RSV Vaccines for Older Adults

You’ll see changes to the respiratory syncytial virus (RSV) immunization recommendations in older adults...along with a new vaccine.

Last year, CDC said that healthcare providers should use “shared clinical decision-making” to help adults ages 60 and older decide about RSV vaccination...based on their preferences, values, etc.

Now guidelines are more clear-cut...and specify which patients should get vaccinated based on their risk of severe illness from RSV.

Expect your pharmacist to recommend RSV vaccination for ALL patients ages 75 and older...plus those 60 to 74 with conditions that increase the risk of severe RSV disease.

For example, watch for patients who have heart, lung, or kidney disease...diabetes with organ damage (neuropathy, etc)...a body mass index (BMI) of 40 kg/m2 or higher...or who are immunocompromised.

Be aware that RSV vaccines are no longer recommended for patients 60 to 74 withOUT risk factors...they’re not as likely to benefit.

And CDC doesn’t yet endorse vaccination for patients 50 to 59...even though Arexvy is FDA-approved for these ages.

If patients over 60 already got an RSV vaccine, don’t offer them 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.

Encourage patients who need an RSV vaccine to get it between August and October...to maximize benefit ahead of RSV season.

Anticipate giving 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...CDC has no preference for one product over another...and any option is covered by Medicare Part D.

Be familiar with 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.

Keep in mind 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...so patients won’t have to wait for mRESVIA to thaw.

Find more product comparisons and other guidance in our resource, Preventing RSV...including recommendations for pregnant patients.

Key References

  • 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).
Pharmacy Technician's Letter. August 2024, No. 400801



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