Prescribers are preparing for another cold and flu season involving respiratory syncytial virus (RSV).
We know RSV is the most common cause of infant hospitalizations...and older adults can have serious complications (intubation, etc).
Prepare for questions about who can get RSV immunizations.
Unvaccinated older adults are eligible for immunization if they are 75 and up...or 50 to 74 with certain risk factors (COPD, diabetes, etc).
Steer toward any of the adult vaccines...Abrysvo, Arexvy, or mResvia. Compare options with our RSV Vaccines chart.
Ideally vaccinate in late summer or early fall depending on when your region’s RSV season starts.
Be aware that FDA approved Abrysvo and mResvia for high-risk adults between 18 and 49 years. But the Advisory Committee on Immunization Practices doesn’t recommend routine RSV vaccination for these patients until we have more safety and efficacy data.
Write for Abrysvo for unvaccinated moms between 32 and 36 weeks of pregnancy...in September to January...to pass antibodies to their baby.
Avoid Arexvy and mResvia...they are NOT approved in pregnancy.
For moms vaccinated this season, clarify that their newborn won’t need their own RSV immunization after delivery.
But specify their baby is eligible for clesrovimab or nirsevimab immunization...ideally within 1 week after birth...if mom delivers within 2 weeks after getting Abrysvo or if her dose was in a PRIOR pregnancy. Get our RSV Monoclonal Antibodies chart for dosing, etc.
Compare product differences to avoid errors.
For example, point out that Abrysvo and Arexvy are refrigerated while mResvia is frozen. And only Abrysvo and Arexvy are reconstituted.
Watch for Abrysvo product changes. The vial and diluent syringe kits are being phased out. This year, expect to only get the dual-chamber Act-O-Vial version that mixes drug and diluent when activated.
Limit confusion by ideally stocking the fewest product options needed to cover your patient population. For example, consider prioritizing Abrysvo if you serve both pregnant and older adults.
Know that we don’t have evidence or recommendations yet for giving adults more than 1 vaccine dose. Check vaccine records carefully to ensure adults only get 1 lifetime dose for now.
Use our Preventing RSV chart to answer questions about RSV risk factors, who should get immunized, and more.
- CDC. RSV Vaccine Guidance for Adults. July 8, 2025. https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/adults.html (Accessed September 16, 2025).
- The American College of Obstetricians and Gynecologists. Maternal Respiratory Syncytial Virus Vaccination. August 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2023/09/maternal-respiratory-syncytial-virus-vaccination (Accessed September 16, 2025).
- Committee on Infectious Diseases. Recommendations for the Prevention of RSV Disease in Infants and Children: Policy Statement. Pediatrics. 2025 Aug 19. doi: 10.1542/peds.2025-073923.
- Chart: Preventing RSV
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Chart:
RSV Vaccines
- Chart: RSV Monoclonal Antibodies