Respiratory Syncytial Virus might not be the first thing that comes to mind when you think of seasonal vaccines, but RSV still deserves some recognition.
Except, wait, what is RSV?
If you haven’t heard of it, Respiratory Syncytial Virus is a common respiratory virus that usually causes mild, cold-like symptoms. These symptoms range from runny nose and coughing to a decrease in appetite, sneezing, fever, and wheezing. Most people recover in a week or two, but this illness can be serious. Some cases of RSV can result in shortness of breath and low oxygen levels.
Read on for how RSV spreads, what’s new for 2026-2027, when to get vaccinated, and more.
In This Article:
- RSV review: what we know
- What’s new this year
- Current clinical guidelines
- Who should and shouldn’t get it
- The best time to get vaccinated
- Side effects and efficacy, including an honest look at the GBS question
PLEASE NOTE: We research and reference this information, but also express opinions of the experienced professionals of Village Apothecary. We are pharmacists, but we may not be YOUR pharmacist. Do not make any medical decisions without first contacting your primary care provider.
RSV Disease and Vaccine Review: What We Know
RSV Disease
Remember when we all washed each and every item we got from the grocery store in the early COVID-19 days? It turned out that we didn’t really need to be doing that, as COVID-19 spreads primarily through droplets from breathing and coughing.
When it comes to RSV, however, washing hands, doorknobs, and commonly touched items is imperative. Why? Well, RSV can be spread by touching a surface that has the virus on it and then touching your face before washing your hands.
But it’s actually a double-whammy. RSV, like COVID-19, can also spread through direct contact with the virus. (Think: droplets from another person’s sneeze getting in your eyes, nose, or mouth.) And the symptoms are nothing to sneeze at either.
RSV can cause inflammation of the small airways in the lung, as well as lung infection. This illness can also sometimes lead to the worsening of other medical conditions such as asthma, chronic obstructive pulmonary disease (a chronic disease of the lungs that makes it hard to breathe), or congestive heart failure (when the heart can’t pump enough blood and oxygen throughout the body).
Older adults and infants who get very sick from RSV may need to be hospitalized, and some may even die. Hence why RSV vaccines are so crucial, despite the illness being common and often mild.
RSV Vaccines
RSV vaccines help prevent lower respiratory tract disease (LRTD) caused by RSV.
Data from a large clinical trial found that a single dose of Arexvy (GSK) reduced symptomatic RSV LRTD by 82.6% during the first RSV season after vaccination compared to placebo, and by 56.1% during the second season.
Real-world data has held up well. Studies from the 2023-24 season showed Arexvy and Abrysvo roughly 77-83% effective at preventing RSV-associated hospitalizations in adults 60+. More recently, a CDC research network found about 57% effectiveness against RSV hospitalization measured across two full seasons in adults 60 and older — a good illustration of protection that’s strong initially, then real but reduced by year two.
What’s New This Year? 2026-2027 RSV Vaccine Updates
Two things worth knowing, and they don’t line up neatly — so read both.
1. All three vaccines now carry much broader FDA approvals.
Over the past two years, every RSV vaccine has expanded well below its original 60+ indications. As of March 2026, all three are FDA-approved for adults 18 to 49 at increased risk, in addition to older adults.
2. The recommendation did not expand with the labels.
CDC guidance still centers on adults 75 and older, plus adults 50 to 74 at increased risk. The 18-49 question has been under review, but there’s no recommendation for routine use in that group.
That gap between “approved for” and “recommended for” matters in practice — it affects coverage, and it affects the conversation. If you’re under 50 with a qualifying condition and think you’d benefit, that’s a legitimate discussion to have with your provider or with us. It’s just not currently a routine recommendation.
Still true and worth repeating: RSV vaccination is not annual. A single dose is what’s recommended. Studies on whether older adults would benefit from a repeat dose are ongoing, but revaccination is not currently advised.
From our shelves: we stock mRESVIA. Call ahead if you specifically need Arexvy or Abrysvo so we can tell you what we can do.
Current Clinical Guidelines for the RSV Vaccine
You’re eligible if:
- You are an adult 75 or older who hasn’t yet received an RSV vaccine.
- You are an adult 50 to 74 at increased risk of severe RSV.
- You are pregnant and in weeks 32 through 36 of pregnancy.
“Increased risk” includes chronic cardiovascular or lung disease, end-stage renal disease, chronic liver disease, diabetes, severe obesity, immune compromise, or living in a nursing home or long-term care facility. That’s not an exhaustive list — ask us.
If you’re already vaccinated, you’re likely done. This is the most common question we get, and the answer surprises people who are used to annual flu shots. Check your records, or let us check for you.
Still have questions about eligibility? Chat with one of our experts.
What RSV Vaccines Are Available?
Three brands:
- Arexvy (GSK) — protein-based, adjuvanted. Not for use in pregnancy.
- Abrysvo (Pfizer) — protein-based. The only one used in pregnancy.
- mRESVIA (Moderna) — mRNA.
For adults 50 and older, none is preferred over the others. Take what’s available. The exception is pregnancy, where Abrysvo is the one.
Our Recommendations
Who Should Get The RSV Vaccine?
- Adults 75 and older who haven’t had one. Straightforward.
- Adults 50 to 74 at increased risk — this is the group most likely to be under-vaccinated, partly because the eligibility age has moved twice in three years. If someone told you a couple of years ago that you were too young, check again.
- Pregnant patients at 32-36 weeks, using Abrysvo, to protect the newborn during their most vulnerable months.
- The decision may be informed by your health status, your risk of severe RSV, your provider’s clinical judgment, your own preferences, and the safety profile of the products.
- Adults with a minor acute illness, like a cold, can still receive the vaccine.
Who Shouldn’t Get The RSV Vaccine?
- Anyone with a history of severe allergic reaction, such as anaphylaxis, to any component of the vaccine.
- Adults with a moderate or severe acute illness, with or without fever, should wait until they’ve recovered.
- Arexvy is not for use in pregnancy — if you’re pregnant, Abrysvo is the product.
Learn More: Vaccine Ingredients in 2026: Less Scary Than You Might Think
When is the Best Time to Get the RSV Vaccine?
“Basically, late summer to early fall. Get it before the COVID and flu rush starts — you’ll get more of our attention and we’ll have more time to talk it through.” — Dr. Neal Smoller
Ideally, vaccination happens before RSV season ramps up in the fall. We push people toward August for a practical reason: RSV vaccines take longer to prepare, and once September hits, pharmacies get slammed.
In some locations — the territories, Hawaii, Alaska, and parts of Florida — RSV circulates on a different schedule than the rest of the country.
Learn More: Seasonal Vaccination: When Should You Get Your Vaccines in 2026?
Side Note: Are There Side Effects to the RSV Vaccine?
“The most commonly reported side effects after RSV vaccination include pain, redness, and swelling where the shot is given, plus fatigue, headache, and muscle or joint pain. Generally, these side effects are very mild and don’t last more than 1-2 days.” — Dr. Neal Smoller
Worth noting: the younger you are, the more likely you are to feel it. In trials, adults 18-49 reported muscle aches and fatigue at noticeably higher rates than adults 50-59. Your immune system is doing its job.
About Guillain-Barré syndrome
Our earlier version of this article said it was unclear whether RSV vaccines caused the GBS cases seen in trials. We owe you an update, because the evidence has firmed up since then.
There does appear to be a small increased risk of GBS after RSV vaccination in older adults. Post-licensure surveillance in the U.S. found an elevated rate, confirmed in follow-up analysis. One large analysis estimated roughly 18 excess cases per million doses of Abrysvo and roughly 5 per million doses of Arexvy. A national study in England covering 2.5 million people aged 75-79 independently found an increased risk as well.
Here’s how we’d ask you to hold that.
GBS is a serious condition — a rare disorder in which the immune system attacks nerves, usually causing weakness that resolves over weeks to months, though recovery can be slow. It deserves to be taken seriously, and we’re not going to wave it off.
It is also genuinely rare at these rates. Eighteen per million is roughly one case in 55,000 doses. Meanwhile, RSV itself sends over 100,000 older adults to the hospital annually and kills thousands. There’s also evidence that RSV infection can trigger GBS — meaning some of the cases prevented by vaccination may partly offset the cases associated with it.
CDC’s assessment, published in 2026, is that the benefits of RSV vaccination continue to outweigh the risks in older adults. We agree with that read. But you deserve the actual numbers rather than a shrug, and if this is the thing making you hesitate, come talk to us about it directly.
One more note: the risk estimates differed between products in that analysis. If that matters to you, it’s a reasonable thing to raise with us.
About pregnancy
Preterm birth was flagged as a possible concern in earlier clinical trial data. More recent evidence is reassuring: a significant association with preterm birth was not observed when Abrysvo was given at 32 to 36 weeks’ gestation — which is precisely why the recommended window is what it is.
Are RSV Vaccines Effective?
Short version: yes, substantially, for at least two seasons.
The Arexvy trial found an 82.6% reduction in symptomatic RSV LRTD in the first season and 56.1% in the second. That efficacy held up across subgroups — people 70 and older, people with and without chronic conditions, and both fit and pre-frail participants. The vaccine worked as well against serious cases requiring medical care as against milder ones.
Real-world data since then has been consistent: strong protection against hospitalization in year one, meaningfully reduced but still real protection in year two. Duration beyond two seasons is still being studied, which is exactly why the revaccination question remains open rather than settled.
But don’t forget that vaccines don’t work like a forcefield — they weren’t designed to. They’re a powerful aid to help prevent dangerous illness, and one tool in the toolbox.
Even supported by healthy lifestyle choices and minimized exposure, vaccines aren’t perfect. But these days, thankfully, they’re very, very good.
Even supported by healthy lifestyle choices and minimized exposure, vaccines aren’t perfect. But these days, thankfully, they’re very, very good.
Learn More: Vaccines Do Work, But They’re Not Perfect
RSV? Not for Me!
Long story short: if you’ve already received an RSV vaccine, you’re probably covered — this isn’t an annual shot.
If you’re 75 or older, pregnant, or 50 to 74 with a condition that raises your risk, this one’s worth a conversation. And if you’re under 50 with a serious underlying condition, the vaccines are now approved for you even though routine recommendations haven’t caught up. That’s a real discussion, not a closed door.
Give us a call. Our vaccine experts are ready to answer questions, schedule your vaccination, or point you toward more detailed information. Because we’re distinctly not a big-box pharmacy — we’re a team of real people who, believe it or not, really care about your health.