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Recommendations

Adults aged ≥60 years who have medical conditions that increase their risk of severe RSV disease are recommended to receive RSV vaccine

A single dose of RSV vaccine is recommended for adults aged ≥60 years with risk factors for severe RSV disease. See Table. Conditions associated with increased risk of severe RSV disease in adults.

RSV vaccine may be given at any time of the year but, where possible, should be offered before the start of the RSV season.

Either Abrysvo or Arexvy may be used, with no brand preference.

Protection lasts for at least 2 years, and the need for further doses has not been established.

Table. Conditions associated with increased risk of severe RSV disease in adults

Adults aged ≥60 years with the medical conditions listed below are at increased risk of severe RSV disease and are recommended to receive RSV vaccine. These examples are not exhaustive, and providers may include people with conditions similar to those listed below based on clinical judgement.

Risk category Example medical condition
Cardiac disease
  • Congenital heart disease
  • Congestive heart failure
  • Coronary artery disease
Chronic respiratory conditions
  • Suppurative lung disease
  • Bronchiectasis
  • Cystic fibrosis
  • Chronic obstructive pulmonary disease
  • Chronic emphysema
  • Severe asthma (requiring frequent medical consultations or the use of multiple medications)
Immunocompromising conditions
  • HIV infection
  • Malignancy
  • Immunocompromise due to disease or treatment
  • Asplenia or splenic dysfunction
  • Solid organ transplant
  • Haematopoietic stem cell transplant
  • CAR T-cell therapy 
Chronic metabolic disorders
  • Type 1 or 2 diabetes
  • Amino acid disorders
  • Carbohydrate disorders
  • Cholesterol biosynthesis disorders
  • Fatty acid oxidation defects
  • Lactic acidosis
  • Mitochondrial disorders
  • Organic acid disorders
  • Urea cycle disorders
  • Vitamin/cofactor disorders
  • Porphyrias
Chronic kidney disease
  • Stage 4 or 5
Chronic neurological conditions
  • Hereditary and degenerative central nervous system diseases
  • Seizure disorders
  • Spinal cord injuries
  • Neuromuscular disorders
  • Other conditions that increase the risk of severe outcomes from respiratory infection
Obesity
  • Body mas index ≥30 kg per m2
Related diseases
Respiratory syncytial virus (RSV)

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