Key Differences Between FDA-Approved RSV Vaccines

EP: 1.Important Background Information on RSV for Pharmacists

EP: 2.Pathophysiology and Complications Associated With Respiratory Syncytial Virus (RSV)

EP: 3.Exploring High-Risk Populations for RSV Complications

EP: 4.Implied Vaccine Burden and Associated Misinformation

EP: 5.Targeting Patients at Risk for Severe RSV Disease

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EP: 6.Key Differences Between FDA-Approved RSV Vaccines

EP: 7.Ideal Patient Populations for RSV Vaccination

EP: 8.Pertinent Information for Shared Decision-Making

EP: 9.Additional Clinical Considerations for RSV Vaccination

EP: 10.Common Causes of RSV Vaccine Hesitancy

EP: 11.Building Trust With Vaccine-Hesitant Patients

EP: 12.Optimizing Multidisciplinary Care in RSV Vaccination Efforts

EP: 13.Best Practices in the Coadministration of Respiratory Vaccines

EP: 14.Future Management Considerations of RSV

Currently, 3 FDA-approved RSV vaccines are available for high-risk adults, each with unique mechanisms and formulations. Two of these are recombinant protein-based vaccines: one is adjuvanted, and the other is a bivalent vaccine targeting both RSV-A and RSV-B subtypes. The third option is an mRNA-based vaccine. All 3 target the prefusion F protein—a key structure on the surface of the RSV virus that enables it to enter human cells. By presenting this protein to the immune system, the vaccines prompt the body to develop protective antibodies.

The recombinant vaccines use a lab-produced version of the prefusion F protein. The adjuvanted vaccine includes an immune-boosting agent to enhance response, while the bivalent version covers both main viral subgroups, offering broader protection. The mRNA vaccine, by contrast, delivers genetic instructions for the body to temporarily produce the prefusion F protein, triggering an immune response without altering the body’s DNA. It's important to clarify that mRNA vaccines do not integrate with a person’s genetic material, a common misconception that can fuel hesitancy.

Aside from their biological differences, these vaccines also vary in their preparation and administration. The two recombinant vaccines require reconstitution prior to intramuscular injection, which adds an extra preparation step for health care providers. In contrast, the mRNA vaccine comes in a ready-to-use prefilled syringe, potentially simplifying the vaccination process. Understanding these differences helps providers select the most appropriate option for their patients and address questions around efficacy, safety, and logistics. Education around both the science and the delivery process is essential to improving acceptance and uptake, particularly among older adults and those managing chronic health conditions.