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Adult RSV Vaccines FAQ
The ABCs of RSV: Q&A From a Live Webinar

Released: June 16, 2025

Expiration: June 15, 2026

Laura P. Hurley
Laura P. Hurley, MD, MPH
Carina Marquez
Carina Marquez, MD, MPH
Sarah McQueen
Sarah McQueen, DMS, PA-C
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Key Takeaways
  • The ABCs of RSV vaccination provide a simple mnemonic to identify vaccine candidates, facilitate vaccine discussions, and follow-up on vaccine recommendations.

Let’s talk about the ABCs of RSV. Everybody loves a catchy slogan, but what does it really mean?

A: Assess Every Patient
That is easy to do, right? We all have time to look at each patient’s vaccine record when they come in. We should get into the habit of doing it; it is about making respiratory syncytial virus (RSV) vaccination a priority. You need to assess each patient to know whether they have been, or should be, vaccinated for RSV. This is especially important for patients with comorbidities that contribute to increased risk of severe RSV, and for  patients older than 75 years of age.

B: Bring Up Vaccinations
Once you have assessed whether a patient is a candidate for RSV vaccination, the next step is initiating the discussion about why the RSV vaccine is needed and what benefits it provides. That could be as simple as making the RSV vaccine part of yearly health discussions during annual wellness visits. Flu vaccine season provides another opportunity to address RSV vaccines and could facilitate vaccine coadministration.

C: Confirm Their Vaccination
Follow up on patients’ vaccine status. Vaccine discussions are not a one-time deal. If you have already talked to your patients, you should follow up with them to see if they made the choice to get vaccinated. Do not just leave them hanging. Often, resolving vaccine hesitancy is a gradual process, and continuing discussions are necessary to improve patients’ vaccine confidence and improve vaccine uptake.

How long does immunity last? 

Sarah McQueen, DMS, PA-C:
If the answer was in a magic 8 ball, it would say “outcome unclear.” We do not have that information right now. Long-term studies on the RSVpreF and the RSVPreF3 adjuvanted vaccine have been completed, and they show that these vaccines provide durable protection against RSV infection across at least 3 RSV seasons. However, more data are needed to determine protection beyond that, as well as to determine long-term efficacy of the mRNA vaccine.

Do patients who received an RSV vaccine during infancy also need one as an adult? 

Carina Marquez, MD, MPH:
To clarify, nirsevimab is a monoclonal antibody that conveys passive immunity to RSV­—it provides protection against RSV infection, but it is not a vaccine by definition because it does not elicit an immune response. So, the immunity from the childhood RSV vaccine, nirsevimab, would wear off eventually, and patients who received that vaccine during infancy would need to be vaccinated again as an older adult.

In the pivotal trials that led to the FDA approval of the RSVpreF and RSVPreF3 vaccines, did the participants who developed Guillain-Barré syndrome (GBS) also have heart failure or chronic kidney disease? 

Laura P. Hurley, MD, MPH:
To clarify, there were 3 individuals in the pivotal trials who developed GBS after RSV vaccination: 2 after RSVpreF and 1 after RSVPreF3. The clinical makeup of those individuals was not reported in such an individual level of detail, but it is an interesting question. However, the main takeaway from these clinical trials and the postmarketing analysis of RSV vaccine–associated GBS is that the risk of GBS with the RSV vaccine is low and comparable to the GBS risk with other widely used vaccines, namely the seasonal influenza and zoster vaccines.

Your Thoughts
Do you have questions about adult RSV vaccines that were not answered here? Check out the accompanying webcast for more coverage of RSV vaccination and leave a comment to join the discussion!