When most people hear “RSV,” they picture a stuffy-nosed toddler. It’s long been known as a childhood illness, the leading reason babies end up in the hospital with breathing trouble. But respiratory syncytial virus is also a serious threat at the other end of life, and it has been flying under the radar for older adults for years.
Key Takeaways
- RSV causes an estimated 110,000 to 180,000 hospitalizations among U.S. adults 50 and older each year, according to the CDC, and roughly 6,000 to 10,000 deaths among adults 65 and older.
- The risk of severe illness rises with age and with chronic conditions such as heart disease, lung disease and diabetes.
- The CDC recommends a single dose of RSV vaccine for all adults 75 and older and for adults 50 to 74 at increased risk of severe RSV.
- Uptake is low. As of April 2025, only about 47.5% of adults 75 and older had ever received an RSV vaccine.
- The CDC’s preferred window is August through October, before RSV season peaks in late fall and winter.
Not just a baby’s illness
In healthy younger adults, RSV usually feels like a cold: runny nose, cough, sneezing, sore throat, maybe a low fever. That’s exactly why it gets overlooked. In older adults and people with chronic health conditions, the same virus can spread into the lungs and cause pneumonia. It can also trigger flare-ups of asthma and COPD and worsen heart failure.
The numbers are substantial. The CDC estimates that 110,000 to 180,000 adults 50 and older are hospitalized with RSV each year in the U.S. Among adults 65 and older, it causes an estimated 6,000 to 10,000 deaths a year. Because many adults are never tested for RSV, it’s often mistaken for a bad cold or the flu.
There’s also no specific antiviral medicine for RSV the way there is for flu and COVID-19. Treatment is mostly supportive, such as oxygen and fluids for people who are hospitalized. That makes prevention especially important.
Who’s at highest risk
According to the CDC, the risk of severe RSV illness generally rises with age, especially after 75. It also rises with certain health conditions and circumstances, including:
- Chronic heart disease, such as heart failure or coronary artery disease
- Chronic lung disease, such as COPD or asthma
- Diabetes with complications, or kidney or liver disease
- A weakened immune system
- Severe obesity
- Frailty, or living in a nursing home or other long-term care facility
An advisory committee meeting noted that adults 50 to 59 with certain chronic conditions are hospitalized for RSV at rates similar to adults 75 and older whose only risk factor is age.
What the CDC recommends
RSV vaccines for older adults first became available in 2023. Under current CDC guidance:
- Everyone 75 and older is recommended to get a single dose.
- Adults 50 to 74 at increased risk of severe RSV, because of the conditions above or living in a nursing home, are also recommended to get a single dose. The CDC expanded this to include adults 50 to 59 in June 2025.
It’s a one-time shot, not an annual one. If you’ve already had an RSV vaccine, including last year, the CDC says you should not get another dose at this time. Studies show a single dose protects for at least two RSV seasons, and the vaccines were 73% to 83% effective at preventing RSV-related hospitalizations in adults 60 and older.
Three RSV vaccines are approved for older adults: GSK’s Arexvy, Pfizer’s Abrysvo and Moderna’s mResvia. The CDC says any of the three can be used.
Like any vaccine, RSV vaccines have possible side effects, most commonly a sore arm, fatigue or headache. FDA labeling for two of them also notes a small possible increased risk of Guillain-Barré syndrome, a rare nerve disorder. Your doctor or pharmacist can help you weigh the benefits and risks for your situation.
Many who qualify haven’t gotten it
Despite the risks, many eligible older adults remain unprotected. According to the American Lung Association, citing CDC data, about 47.5% of adults 75 and older had ever received an RSV vaccine as of April 2025, and only about 38% of adults 60 to 74 with a high-risk condition. Part of the problem is awareness. Many people simply don’t know that RSV is a threat to adults, or that a vaccine exists for them.
What to do with this information
Check whether you qualify. If you’re 75 or older, or 50 to 74 with heart disease, lung disease, diabetes complications, a weakened immune system or another high-risk condition, ask your doctor or pharmacist about an RSV vaccine.
Don’t wait too long. The CDC recommends getting vaccinated ideally between August and October, before RSV season peaks. If you miss that window, you can still talk to your provider about getting it later.
Check your coverage. For people with Medicare, RSV vaccines are covered under Part D.
Know the warning signs. Seek medical care for trouble breathing, wheezing, worsening shortness of breath, high fever, bluish lips or a sudden worsening of a chronic condition such as COPD or heart failure.
Use everyday protection. Wash hands often, stay away from people who are sick, and stay home when you’re unwell. These steps help protect you and others during the respiratory virus season.
This article is for general information and isn’t a substitute for advice from your doctor or pharmacist.
Sources:
- CDC, RSV in Adults: https://www.cdc.gov/rsv/adults/index.html
- CDC, Clinical Guidance for RSV Immunizations and Vaccines: https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/index.html
- American Lung Association, RSV for Healthcare Providers: https://www.lung.org/lung-health-diseases/lung-disease-lookup/rsv/rsv-hcp
- Immunize.org, Ask the Experts: RSV: https://www.immunize.org/ask-experts/topic/rsv/
- National Council on Aging, RSV in Older Adults: https://www.ncoa.org/article/what-older-adults-need-to-know-about-rsv/
- National Council on Aging, Vaccines Older Adults Need: https://www.ncoa.org/article/vaccines-older-adults-need-what-to-get-when-to-get-it-and-why-it-matters/