Chloe Ramirez
Respiratory Syncytial Virus (RSV) is a common respiratory illness that spreads in the fall and winter months. It is usually mild but can cause serious illness in children, older adults, and those with weakened immune systems. Vaccines are available for infants, pregnant people, and older adults. While live-attenuated RSV vaccines have been evaluated clinically, the current RSV vaccines are not live vaccines, meaning they do not contain a part of the active RSV virus. Instead, they consist of inactivated RSV proteins that help the body build immunity and fight off future infections.
| Characteristics | Values |
|---|---|
| Type of vaccine | Respiratory Syncytial Virus (RSV) vaccine |
| Who is it for? | Adults at the highest risk of serious illness from RSV infection, infants, pregnant people |
| How often should it be administered? | Once; protection from the vaccine lasts more than a year |
| How is it administered? | Single injection in the upper arm |
| Is it a live vaccine? | No |
| How does it work? | It helps build up immunity to the virus by stimulating innate, humoral, and cellular immunity |
| Is it safe? | Yes, all medicines are tested for safety and efficacy before they are allowed to be used |
| Are there any side effects? | None mentioned |
| Is it effective? | Yes, clinical trials show that the RSV vaccine provides good protection for at least 2 years |
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What You'll Learn
The RSV vaccine is not a live vaccine
The RSV vaccine is recommended for all adults aged 75 and older and those aged 60 to 74 who have risk factors for severe RSV disease. Risk factors include chronic heart or lung disease, a weakened immune system, other medical conditions such as diabetes, and living in a nursing home. The RSV vaccine is also offered during pregnancy, regardless of age.
In Scotland, the RSV programme was launched in August 2024, and by November 2024, 68.6% of eligible older adults had received the vaccine. Clinical trials currently show that the RSV vaccine provides good protection for at least 2 years, and researchers expect that future data will show that immunity lasts even longer.
There are two types of RSV vaccines: monoclonal antibodies and vaccines that are not live vaccines. The monoclonal antibodies include nirsevimab (Beyfortus) and clesrovimab, which are passive immunisations. They are not technically "vaccines" in the traditional sense of active immunisation but are used similarly to routine childhood vaccines. Nirsevimab and clesrovimab are expected to provide long-lasting protection from RSV, reducing the risk of severe RSV disease by about 80%. The other RSV vaccines that are not live include Abrysvo® from Pfizer, Arexvy® from GSK, and mResvia® from Moderna.
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Live-attenuated RSV vaccines are being developed for infants and young children
Respiratory syncytial virus (RSV) is a highly contagious respiratory illness that spreads in autumn and winter. It is the most common cause of lower respiratory tract illness in infants and young children, and it can cause severe illness in young children and older adults. Currently, the only market-approved preventive strategy against RSV infections is the first-generation monoclonal antibody (mAb), palivizumab. However, this is not the preferred preventive strategy for the general infant population.
- They do not cause vaccine-associated enhanced RSV disease.
- They broadly stimulate innate, humoral, and cellular immunity, both systemically and locally in the respiratory tract.
- They are delivered intranasally.
- They replicate in the upper respiratory tract of young infants, even when there are passively acquired maternally derived RSV neutralizing antibodies present.
There have been challenges in maximizing the impact of live-attenuated RSV vaccines. For example, several vaccine candidates had low seroconversion rates due to over-attenuation. Additionally, some vaccines were found to be insufficiently attenuated and may cause severe adverse events in infants under 6 months of age. Furthermore, live-attenuated RSV vaccines are not immunogenic in infants and children who are seropositive for RSV.
Despite these challenges, efforts to develop live-attenuated RSV vaccines continue. Two types of live RSV candidate vaccines made by reverse genetics have been evaluated clinically: the rA2cp248/404/1030ΔSH virus and MEDI-559, a version of the former with several silent mutations. As of the time of writing, MEDI-559 is being evaluated in a phase I-II clinical trial. Another potential vaccine candidate is RSV ΔNS2 Δ1313 I1314L, which is being developed by manipulating or deleting RSV proteins involved in immune evasion or the regulation of RSV gene expression.
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The RSV vaccine is recommended for adults at high risk of serious illness
Respiratory Syncytial Virus (RSV) is a common respiratory illness that spreads in the fall and winter months. RSV is highly contagious and can cause severe lower respiratory infections like pneumonia, especially in older adults, young children, and people with weakened immune systems. To prevent RSV-associated hospitalizations and deaths, the CDC recommends RSV vaccination for high-risk adults.
The CDC advises a single dose of any FDA-licensed RSV vaccine for adults aged 75 and older and those aged 50-74 with an increased risk of severe RSV. The three available vaccines are GSK's Arexvy, Moderna's mResvia, and Pfizer's Abrysvo. While Arexvy and Abrysvo have been associated with an increased risk of Guillain-Barré Syndrome (GBS), a rare neurological condition, the benefits of vaccination in reducing hospitalizations and deaths outweigh this risk.
GSK's Arexvy is a recombinant RSV F protein antigen vaccine based on the RSV-A subtype. It contains an AS01E adjuvant, which is also used in GSK's recombinant zoster vaccine (RZV, Shingrix) but at a lower dose. Arexvy was approximately 77% effective in preventing RSV-associated hospitalizations in adults aged 60 and older during the 2023-2024 RSV season.
Moderna's mResvia is a single 0.5 mL-dose vial containing 50 μg of nucleoside-modified mRNA encoding the RSV F glycoprotein, stabilized in the prefusion conformation. In clinical trials, mResvia demonstrated approximately 80% efficacy against symptomatic RSV during the first four months following vaccination and approximately 56% efficacy during the first 12 months.
Pfizer's Abrysvo is a recombinant RSV F protein antigen vaccine based on both the RSV-A and RSV-B subtypes. It is supplied as a single-dose vial of 120 μg of lyophilized preF antigen component to be reconstituted with sterile water. While the Abrysvo vaccine is not a live vaccine and does not cause RSV infection, it helps build immunity to protect against severe illness.
In summary, the RSV vaccine is recommended for adults aged 75 and older and those aged 50-74 with an increased risk of severe RSV. The CDC currently advises a single dose of an age-appropriate RSV vaccine from the three available options: GSK's Arexvy, Moderna's mResvia, or Pfizer's Abrysvo. While the Arexvy and Abrysvo vaccines have been linked to an increased risk of GBS, the benefits of vaccination in preventing hospitalizations and deaths outweigh this risk.
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The vaccine is also offered to pregnant people
The RSV vaccine is also offered to pregnant people. RSV, or respiratory syncytial virus, is a common respiratory illness that can cause severe lower respiratory infections like pneumonia, and other life-threatening conditions. The vaccine helps to protect against severe illness by reducing the chances of getting an RSV infection.
Pregnant women should get a single dose of the maternal RSV vaccine, Pfizer's Abrysvo, during weeks 32 through 36 of pregnancy. This vaccine is administered between September and January in most of the United States. The vaccine is administered intramuscularly in the deltoid region of the upper arm. It is important to note that pregnant women who are more than 36 weeks and 6 days pregnant should not be vaccinated, as there may not be enough time for the antibodies to develop and protect the infant.
The maternal RSV vaccine is recommended to protect babies from severe RSV disease. The protection provided by the maternal vaccine passes from the mother to the baby and lasts for the first RSV season, typically the fall and winter months. Babies will be born 1-2 months after the mother is vaccinated and will have immediate protection against RSV. Clinical trials show that the RSV vaccine provides good protection for at least 2 years, and researchers expect that it may last even longer.
It is important to note that Pfizer's Abrysvo is the only RSV vaccine recommended for pregnant women. Other vaccines, such as GSK's Arexvy and Moderna's mResvia, are not approved for use during pregnancy.
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The shot contains inactivated RSV proteins
The RSV vaccine is a shot that protects you from respiratory syncytial virus (RSV) infections, which affect the lungs and respiratory tract. RSV is a highly contagious illness that spreads in the fall and winter months. It usually causes mild cold symptoms, but it can be severe in children, older adults, and those with immune system problems, heart issues, or lung issues.
The RSV vaccine is recommended for adults aged 75 and older and those aged 60 to 74 with risk factors for severe RSV disease, such as chronic heart or lung disease, a weakened immune system, or other medical conditions. The vaccine is also available for pregnant people and helps protect the baby after birth. Clinical trials show that the RSV vaccine provides good protection for at least two years, and researchers expect it to last even longer.
While the RSV vaccine is effective in preventing severe illness, it is not a live vaccine. It does not cause RSV infection and helps build up your immunity to the virus. This is different from live-attenuated RSV vaccines, which are being developed for infants and young children. These vaccines are designed to stimulate the immune system both systemically and locally in the respiratory tract, providing protection against RSV disease.
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Frequently asked questions
No, the RSV vaccine is not a live vaccine. It does not contain a part of the RSV virus itself.
The RSV vaccine is being offered to adults at the highest risk of serious illness from RSV infection. The CDC recommends that all adults ages 75 and older and those ages 60 to 74 with risk factors for severe RSV disease get one of the three RSV vaccines. The RSV vaccine is also offered during pregnancy, regardless of age.
The RSV vaccine helps build up your immunity to the virus. This means your body will fight off the infection more easily. The inactivated protein in the vaccine signals your immune system to recognize the actual virus if it were to enter your body.
Clinical trials currently show that the RSV vaccine provides good protection for at least 2 years. Researchers expect that future data will show that the vaccine will last even longer.
