RSV vaccination is recommended for three main groups: adults 75 and older (and some adults 60–74 with risk factors), pregnant women during a specific window of pregnancy, and infants entering their first RSV season. The recommendations differ for each group, so the details matter.
Adults 75 and Older
If you’re 75 or older, the CDC recommends RSV vaccination regardless of other health conditions. Age alone puts you at significantly higher risk for severe RSV illness, which can lead to pneumonia, hospitalization, and death in older adults. A single dose of an RSV vaccine reduces RSV-related hospitalizations by roughly 55–65%, depending on which vaccine you receive.
Adults 60–74 With Risk Factors
For adults between 60 and 74, vaccination isn’t a blanket recommendation. Instead, it’s based on whether you have specific conditions that raise your risk for severe RSV. The qualifying conditions are broader than many people expect:
- Chronic heart disease such as heart failure, coronary artery disease, or congenital heart disease (high blood pressure alone doesn’t qualify)
- Chronic lung disease including COPD, emphysema, asthma, interstitial lung disease, or cystic fibrosis
- Diabetes with complications such as kidney disease, nerve damage, or retinopathy, or diabetes treated with insulin
- Kidney disease requiring dialysis or other renal replacement therapy
- Weakened immune system from medications, cancer treatment, organ transplant, or other causes
- Neurologic conditions that impair swallowing or weaken the muscles used for breathing
- Chronic liver disease such as cirrhosis
- Severe obesity with a BMI of 40 or higher
- Chronic blood disorders like sickle cell disease
- Living in a nursing home
Your doctor can also recommend the vaccine if they believe other factors put you at elevated risk, including general frailty or living in a remote area where getting to a hospital quickly would be difficult.
People With Weakened Immune Systems
The Infectious Diseases Society of America issued guidelines in 2025 strongly recommending RSV vaccination for adults and adolescents with compromised immunity. This includes people who’ve had organ transplants, those on immunosuppressive medications, and people with blood cancers or HIV. The timing of vaccination matters more for this group. If you’re undergoing treatments that suppress your immune system (like therapies that deplete certain immune cells), your doctor may want to schedule the vaccine around your treatment cycles to give your body the best chance of building a protective response.
Pregnant Women
Pregnant women can get a single dose of the RSV vaccine during weeks 32 through 36 of pregnancy, administered between September and January. The vaccine doesn’t protect the pregnant person so much as it protects their baby. Antibodies cross the placenta and shield the newborn during their most vulnerable first months of life. This approach reduces infant RSV hospitalizations by about 68–72%.
Timing is tight for a reason. Getting vaccinated before 32 weeks means the antibodies may not be at peak levels at birth. Getting vaccinated after 36 weeks and 6 days doesn’t leave enough time for antibodies to build up and transfer to the baby. The September-through-January window aligns with the start of RSV season, so the baby has protection when it matters most.
Infants and Young Children
Babies don’t receive a traditional vaccine. Instead, they get a protective antibody injection that works immediately rather than training the immune system to respond over time. This is recommended for infants younger than 8 months who are born during or entering their first RSV season (typically fall through spring) if their mother didn’t receive the RSV vaccine during pregnancy, if the mother’s vaccination status is unknown, or if the baby was born within 14 days of maternal vaccination. In those cases, there wasn’t enough time for maternal antibodies to transfer.
For a smaller group of high-risk children between 8 and 19 months, protection is recommended heading into their second RSV season. This includes children with chronic lung disease from premature birth who needed oxygen or other respiratory support in the six months before RSV season, children with severely weakened immune systems, children with cystic fibrosis and serious lung involvement or low weight, and American Indian or Alaska Native children. Children 8 months and older without these risk factors are not recommended to receive it, and the antibody product is not approved for anyone 20 months or older.
How Well the Vaccines Work
The three RSV vaccines available for adults each offer meaningful but not perfect protection. In adults 60 and older, one vaccine reduces RSV-related hospitalizations by about 65%, another by 58–63%, and the third by roughly 55%. These numbers are comparable to flu vaccine performance in a good year. The maternal vaccine stands out for infant protection, cutting RSV hospitalizations in babies under 6 months by about 72%.
Side Effects and Safety
About 42% of vaccinated adults experience some reaction at the injection site, typically soreness, redness, or swelling. Around 32% report systemic effects like fatigue, headache, or muscle aches. These are generally mild and resolve within a couple of days.
The more serious concern is a rare neurological condition called Guillain-Barré syndrome, which causes temporary muscle weakness and, in severe cases, paralysis. Surveillance data estimates the added risk at roughly 5 to 18 extra cases per million doses, depending on the vaccine. To put that in perspective, for every million people vaccinated, the vast majority (999,982 or more) will not develop this complication. This small risk is one reason the recommendation for adults 60–74 is tied to specific risk factors rather than being universal. For people 75 and older or those with conditions that make severe RSV dangerous, the benefit of preventing hospitalization and death clearly outweighs this rare risk.
Cost and Insurance Coverage
If you have Medicare Part D or a Medicare Advantage plan with drug coverage, RSV vaccination is covered with no copay and no deductible. This applies to all vaccines recommended by the CDC’s Advisory Committee on Immunization Practices. Most private insurance plans cover recommended vaccines as well, though you should confirm with your plan. For the infant antibody injection, coverage typically falls under the child’s insurance plan. If you don’t have insurance, ask your provider about costs upfront, as the RSV vaccine can be expensive out of pocket.
When to Get Vaccinated
RSV season in the United States generally runs from fall through spring, with cases peaking in winter. For adults, getting vaccinated before the season starts gives your immune system time to build protection. For pregnant women, the September-through-January window is specifically designed so that babies born during peak RSV months arrive with protective antibodies already in their system. Infants should receive their antibody injection shortly before or early in RSV season for the same reason.