RSV Vaccine 2025: 5 Critical Things You Must Know Now
Get the latest on the RSV vaccine for 2025. We cover eligibility for seniors and pregnant women, compare Arexvy vs. Abrysvo, and detail cost and safety.
Dr. Elena Vance
Public health physician specializing in infectious diseases and vaccine-preventable illnesses.
What is RSV and Why is a Vaccine Important?
Respiratory Syncytial Virus, or RSV, has long been known as a common, cold-like nuisance for most healthy adults. However, for the very young and older adults, it's a different story. RSV can lead to severe respiratory illness, including bronchiolitis (inflammation of the small airways in the lungs) and pneumonia. Each year in the U.S., RSV is responsible for up to 160,000 hospitalizations and 10,000 deaths among adults aged 65 and older.
For decades, a safe and effective RSV vaccine remained an elusive goal for scientists. But recent breakthroughs have changed the landscape entirely. With multiple vaccines now available, 2025 marks a pivotal year in our fight against this pervasive virus. Understanding the options, who they're for, and what to expect is more critical than ever. This guide breaks down the five most important things you need to know now.
1. Who is Eligible for the RSV Vaccine in 2025?
As we move into 2025, the recommendations for RSV immunization have become more established, targeting the most vulnerable populations. Eligibility is primarily focused on two key groups, with a third protective option for infants.
Older Adults (Ages 60 and Up)
The CDC recommends that adults aged 60 and older may receive a single dose of an RSV vaccine. The guidance uses the language of shared clinical decision-making. This means you should have a conversation with your healthcare provider to determine if the vaccine is right for you, based on your personal health status, risk factors (like chronic heart or lung disease), and preferences. This recommendation is expected to remain firm throughout 2025.
Pregnant Individuals
To protect newborns from severe RSV during their first few months of life, the CDC recommends a single dose of Pfizer's Abrysvo vaccine for pregnant individuals between 32 and 36 weeks of gestation. The antibodies developed by the mother are passed to the fetus, providing crucial passive immunity from birth. This is a seasonal recommendation, typically administered from September through January in most of the U.S.
Infants and Young Children (Monoclonal Antibody)
It's important to distinguish the vaccine from the primary preventive option for infants: nirsevimab (brand name Beyfortus). This is not a vaccine but a long-acting monoclonal antibody shot. It provides direct, passive immunity against RSV. The CDC recommends it for:
- All infants under 8 months born during or entering their first RSV season.
- Children aged 8-19 months who are at increased risk for severe RSV disease and entering their second RSV season.
An infant only needs protection from either the maternal vaccine or the nirsevimab shot, not both.
2. Comparing the Top RSV Vaccines: Arexvy vs. Abrysvo vs. mRNA-1345
The 2025 RSV vaccine market is dominated by two established players, with a promising new mRNA candidate making waves. While all are designed to prevent RSV-related lower respiratory tract disease (LRTD), they have key differences.
| Feature | GSK Arexvy | Pfizer Abrysvo | Moderna mRNA-1345 (Spikevax RSV) |
|---|---|---|---|
| Vaccine Type | Adjuvanted recombinant subunit | Bivalent recombinant subunit | mRNA (messenger RNA) |
| Approved For | Adults 60+ | Adults 60+ and Pregnant Individuals (32-36 weeks) | Adults 60+ (Full approval widely anticipated by early 2025) |
| Mechanism | Uses a lab-made RSV protein with an adjuvant to boost immune response. | Uses two lab-made RSV proteins to stimulate immunity. | Provides cells with instructions (mRNA) to make a key RSV protein, triggering an immune response. |
| Administration | Single intramuscular dose | Single intramuscular dose | Single intramuscular dose |
| Reported Efficacy (vs. LRTD) | ~83% in the first season; ~77% cumulative over two seasons. | ~89% in the first season; ~78% through the middle of the second season. | ~84% against LRTD with 2+ symptoms in its pivotal trial. |
Note: Efficacy data is based on clinical trials and may evolve with real-world evidence.
3. Efficacy and Safety: What the Latest Data Says
Both approved vaccines have demonstrated high efficacy in preventing serious outcomes from RSV. The data entering 2025 confirms their value, especially in protecting against severe disease requiring medical attention.
Duration of Protection
A key question for patients and doctors is how long protection lasts. Data from both GSK and Pfizer show that protection extends into a second RSV season after a single dose, though it wanes slightly. As of early 2025, the current recommendation remains a single dose. The CDC's advisory committee (ACIP) will continue to review data to determine if or when a booster dose might be needed in future years.
Safety Profile and Potential Risks
The safety profiles of Arexvy and Abrysvo are generally favorable. The most common side effects are mild and temporary, including:
- Pain, redness, or swelling at the injection site
- Fatigue
- Headache
- Muscle or joint pain
Importantly, post-market surveillance has identified a potential, though very rare, risk of Guillain-Barré syndrome (GBS), a neurological disorder. The estimated risk is about 1.5 cases per million doses administered. This is a key reason for the "shared clinical decision-making" approach, allowing individuals and their doctors to weigh the significant benefits of preventing severe RSV against this very small risk.
4. Cost, Insurance Coverage, and Availability
For most eligible individuals in the U.S., the RSV vaccine should be available at no out-of-pocket cost. Here’s how coverage generally works:
Insurance Coverage
- Medicare: For those on Medicare, the RSV vaccine is covered under Part D (prescription drug plans). Due to the Inflation Reduction Act, vaccines recommended by the ACIP, including the RSV vaccine, are available with no deductible or co-pay.
- Private Insurance: Under the Affordable Care Act (ACA), most private insurance plans are required to cover ACIP-recommended vaccines without cost-sharing. This applies to both the adult and maternal RSV vaccines.
- Medicaid: Coverage for adults is typically provided by state Medicaid programs.
Always check with your specific insurance plan to confirm coverage before getting vaccinated.
Where to Get Vaccinated
RSV vaccines are widely available at major retail pharmacies (like CVS, Walgreens, Rite Aid) as well as at doctors' offices and local health clinics. It is often possible to get your RSV vaccine at the same time as other recommended vaccines, like the annual flu shot.
5. The Future of RSV Prevention: What's Next?
The progress in RSV prevention is not stopping here. The pipeline for 2025 and beyond is robust and focused on expanding protection and convenience.
Combination Vaccines
One of the most exciting developments is the work on combination vaccines. Companies like Moderna and Pfizer are in late-stage trials for single-shot vaccines that would protect against influenza, COVID-19, and RSV simultaneously. This could significantly simplify annual vaccination schedules and improve uptake, potentially becoming available in the next few years.
Expanding Protection to New Groups
Research continues into vaccines for other high-risk groups, including younger adults with chronic conditions and a broader pediatric population. The ultimate goal is to create a comprehensive vaccination strategy that protects all vulnerable individuals from birth through old age, drastically reducing the global burden of RSV.