In an August 2024 publication in the CDC’s Morbidity and Mortality Weekly Report, a panel of experts from the Advisory Committee on Immunization Practices (ACIP) discussed the updated recommendations reflecting the panel’s vote in June 2024 for the use of RSV vaccine, using shared clinical decision-making.

The CDC noted that RSV is a major cause of respiratory illness and hospitalizations in older adults during fall and winter in the United States. The 2023–2024 RSV season was the first during which RSV vaccination was recommended for U.S. adults aged ≥60 years, using shared clinical decision-making.

On June 26, 2024, the ACIP voted to update these recommendations as follows: all adults aged ≥75 years and adults aged 60 to 74 years who are at augmented risk for severe RSV disease should receive a single dose of RSV vaccine.

To update adult RSV vaccination recommendations, the ACIP considered data from previous meetings, new data from randomized, observer-blind, placebo-controlled clinical trials of mRESVIA, and postlicensure data on the other RSV vaccines approved in 2023.

The authors wrote, “This report summarizes the evidence considered for these updated recommendations, including post-licensure data on vaccine effectiveness and safety, and provides clinical guidance for the use of RSV vaccines in adults aged ≥60 years. These updated recommendations are intended to maximize RSV vaccination coverage among persons most likely to benefit, by clarifying who is at highest risk and by reducing implementation barriers associated with the previous shared clinical decision-making recommendation. Continued post-licensure monitoring will guide future recommendations.”

The report revealed that as of spring 2024, 20% to 25% of U.S. adults aged ≥60 years were estimated to have received the RSV vaccine, and the first postlicensure safety and effectiveness data for RSV vaccines approved in 2023 were available. In addition, on May 31, 2024, the FDA approved a third RSV vaccine (mRESVIA [Moderna]) for the prevention of RSV-associated lower respiratory tract disease (RSV-LRTD) in adults aged ≥60 years.

The ACIP experts noted that eligible adults are currently recommended to receive a single dose of RSV vaccine; adults who have already received RSV vaccination should not receive another dose. A single dose provides protection for at least two RSV seasons. The need for additional RSV vaccine doses will be evaluated by ACIP in the future; ACIP will update recommendations as needed.

The ACIP noted that regardless of which vaccine is appropriate based on the patient’s health history, vaccination and its critical role in RSV prevention are vital. In some cases, RSV vaccines can prevent illness altogether, while in others, they offer protection against severe cases of the disease, yielding better health outcomes.

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