RSV vaccine recommendations depend on your age group and risk factors. The CDC recommends the vaccine for all adults 75 and older, for adults 50 to 74 with certain health conditions, for pregnant women during a specific window, and for infants through a protective antibody shot. Here’s how each group breaks down.
Adults 75 and Older
If you’re 75 or older, the recommendation is straightforward: get a single dose of an RSV vaccine. No additional risk factors are needed to qualify. The Advisory Committee on Immunization Practices (ACIP) voted unanimously in June 2024 to make this a routine recommendation for this age group, recognizing that age alone puts you at significantly higher risk for severe RSV illness.
Only one dose is currently recommended. There is no annual booster schedule like the flu shot. The CDC has not yet issued guidance on revaccination, so for now it’s a one-time shot.
Adults 50 to 74 With Risk Factors
For adults between 50 and 74, the vaccine is recommended only if you have an increased risk of severe RSV illness. Qualifying risk factors include:
- Chronic heart or lung disease (such as COPD, asthma, or heart failure)
- A weakened immune system (from medication or a medical condition)
- Other underlying medical conditions that affect respiratory health
- Living in a nursing home or long-term care facility
If you’re in this age range and otherwise healthy, the vaccine isn’t currently recommended for you. Talk with your provider about whether your health history qualifies you.
Pregnant Women: Weeks 32 Through 36
Pregnant women can get an RSV vaccine to protect their newborns, but the timing window is narrow. The CDC recommends one dose of the Abrysvo vaccine between 32 weeks and 36 weeks, 6 days of pregnancy. Getting vaccinated during this window allows your body to produce protective antibodies and pass them to the baby before birth, giving the newborn defense against RSV during their most vulnerable first months.
This maternal vaccine is an alternative to the infant antibody shot described below. In most cases, your baby needs one or the other, not both.
Infants Under 8 Months
Babies don’t receive a traditional vaccine. Instead, infants younger than 8 months get a single dose of nirsevimab, a lab-made antibody that provides immediate protection against RSV. It’s recommended for babies born during or entering their first RSV season (typically fall through spring) if:
- The mother did not receive the RSV vaccine during pregnancy
- The mother’s vaccination status is unknown
- The baby was born within 14 days of the mother’s RSV vaccination (not enough time for antibodies to transfer)
If the mother was vaccinated more than 14 days before delivery, the baby generally has enough inherited antibodies and doesn’t need nirsevimab.
High-Risk Children 8 to 19 Months
Most children don’t need a second season of RSV protection, but some high-risk kids between 8 and 19 months are eligible for nirsevimab before their second RSV season. This includes children with:
- Chronic lung disease of prematurity who needed oxygen, diuretics, or corticosteroids in the six months before RSV season
- Severe immune deficiency
- Cystic fibrosis with significant lung involvement or very low weight for their length
- American Indian or Alaska Native heritage, a group with disproportionately high RSV hospitalization rates
The CDC does not recommend nirsevimab for anyone 20 months or older.
Side Effects by Age Group
In adults 60 and older, about 39% of vaccinated people reported at least one symptom in the week after their shot, based on CDC monitoring of more than 16,000 recipients. Injection site pain was the most common complaint, and most reactions were mild or moderate. Systemic reactions like fatigue, headache, or muscle aches occurred in roughly 22% to 37% of recipients depending on which vaccine product they received.
One rare but serious concern flagged during clinical trials is Guillain-Barré syndrome (GBS), a nerve condition that causes temporary weakness or paralysis. Post-market surveillance found GBS reports at a rate of roughly 1.8 to 4.4 per million doses, which is higher than the expected background rate. The risk is very small in absolute terms, but it’s one reason the vaccine is targeted to people who benefit most rather than recommended broadly for all older adults.
For infants, nirsevimab side effects are typically limited to mild irritability or soreness at the injection site. Serious reactions are rare.
Quick Reference by Age
- Under 8 months: Nirsevimab antibody shot (if mother wasn’t vaccinated during pregnancy)
- 8 to 19 months: Nirsevimab for high-risk children entering second RSV season
- 32 to 36 weeks pregnant: One dose of Abrysvo vaccine
- 50 to 74 years old: One dose if you have qualifying risk factors
- 75 and older: One dose recommended for everyone