Opinion
Video
Author(s):
Panelists discuss the 3 FDA-approved RSV vaccines for high-risk adults—2 recombinant protein-based (1 adjuvanted, 1 bivalent) and one mRNA-based—highlighting differences in formulation, mechanism, and preparation, and emphasizing the importance of education to address misconceptions and guide appropriate vaccine selection.
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.
Stay informed on drug updates, treatment guidelines, and pharmacy practice trends—subscribe to Pharmacy Times for weekly clinical insights.