Clinical Considerations
• Although the evidence was insufficient in adults aged 18 to 59 years who were not pregnant or immunocompromised but were at increased risk for severe RSV, clinicians may consider RSV vaccination based on clinical judgment.
• In adults aged 60 to 74 years who are not at increased risk for severe RSV, the increased risk for developing Guillain–Barré syndrome following administration of a protein subunit RSV vaccine (about 1 per 100 000 person-years) needs to be balanced with the relatively low likelihood of preventing RSV-related hospitalization (30 per 100 000 person-years).
• Discuss adverse events, such as the risk for Guillain–Barré syndrome, and minor and short-term harms, such as fever or injection site soreness.
• Adults aged 75 years or older, those living in a long-term care facility, or those with a comorbid condition (including but not limited to chronic kidney, liver, or lung disease; cardiovascular disease; hematologic conditions [for example, sickle cell disease]; diabetes; obesity; or a combination of these conditions) are at increased risk for severe RSV.
• An RSV vaccine can be administered throughout the year, but the ideal time is early fall for both the Northern and Southern Hemispheres.
• As opposed to other respiratory virus vaccines that are administered annually, the RSV vaccine is currently administered only once. The need for additional vaccination is unknown.
• Some adults may prefer coadministration of RSV and other respiratory virus vaccines, such as an influenza vaccine, which might increase vaccine uptake.
• Adults with recent or active RSV infection should recover before being vaccinated.
• Emphasize that preventive actions (using an alcohol-based hand sanitizer or handwashing with soap and water, appropriately covering sneezes and coughs, and avoiding close contact with others if experiencing an RSV-like illness) can reduce the spread of RSV in combination with vaccination.
