Learning From Last Season: What RSV Rates Tell Us About Vaccination Needs This Year

Each fall and winter, as children return to school, families and friends enjoy holiday celebrations, and individuals of all ages retreat indoors to shield themselves from cooling temperatures, the respiratory virus season begins anew. One of the most common and burdensome respiratory threats during these seasons is respiratory syncytial virus (RSV), which causes cold-like symptoms but can be serious for older adults. The risk necessitates a multifaceted approach to encourage vaccination for at-risk individuals.¹

A critical facet of preparing for each respiratory season involves ongoing infection and vaccination tracking and analysis. No respiratory virus season is the same as another, with infection rates fluctuating yearly based on countless factors. Looking back on data from previous seasons helps inform health care professionals about pertinent trends in virus transmission and populations at the highest risk of infection, as well as the success of public health measures and vaccination strategies. Furthermore, reviewing past vaccination data helps pharmacists adjust their pharmacy-specific protocols for patient outreach and education resources while aiding them in anticipating vaccine demand.

Monitoring infection and vaccination rates is especially important regarding the availability of new vaccines to prevent severe illness in adults. Arexvy (GSK), an RSV vaccine designed to prevent RSV-associated lower respiratory tract disease (LRTD), became the first FDA-approved RSV vaccine in 2023, indicated for adults 60 years and older and those aged 50 to 59 years at increased RSV risk. Abrysvo (Pfizer) was also approved in 2023 for the same original indication as Arexvy, and mRESVIA (Moderna), approved in 2024, carries similar indications for adults 60 years and older and at-risk adults aged 18 through 59 years.^1,2

With these new vaccines that provide robust protection against RSV, it is paramount to analyze seasonal data and understand the impacts of these advancements on older adults, who are at one of the highest risks of severe RSV disease. For pharmacists, as their role grows to encompass more responsibilities related to vaccinating patients, monitoring these trends is becoming part of standard practice—and there are plenty of resources available to aid their efforts in tracking infection, hospitalization, and vaccination rates.

RSV Infections Spike in Winter Months

As previously mentioned, the beginning of fall and winter accompanies more social gatherings indoors. Unfortunately, this often correlates with heightened rates of respiratory virus transmission, and this was no different during the 2024-2025 respiratory season. According to information from the National Respiratory and Enteric Virus Surveillance System (NREVSS), there was a major spike in RSV test positivity from November 2024 to January 2025.³

With families celebrating holiday traditions, RSV was able to gain a foothold in communities, especially around the holidays. For the week of December 21, 2024, the weekly percentage of positive RSV tests reported to NREVSS reached a peak of 10.97% and did not subside to below 10% until well into January 2025. This was a slight reduction compared with the 2023-2024 season, which had an 11.23% positivity rate for the same period and reached a peak of 12.75% earlier in the season in late November 2023, during Thanksgiving celebrations.³

In each of the past 2 RSV seasons, weekly positivity began to recede by April. Year-to-year weekly positivity has decreased according to NREVSS data, but with a sustained peak through multiple winter weeks, the emphasis on vaccination remains essential. Pharmacists could tailor vaccination campaigns to correlate with the weeks preceding holiday gatherings and utilize the upcoming celebrations as a reason that patients should receive an RSV vaccine.³

Hospitalizations Peak, but Quickly Decline

Reviewing hospitalization data is another important aspect of monitoring RSV seasons. Older adults with RSV—especially those with chronic underlying conditions or weakened immune systems—may experience severe symptoms such as dehydration and difficulty breathing that require hospitalization. The administration of oxygen, intravenous fluids, and ventilation could all stem from hospitalizations. These risks mean pharmacists must thoroughly consider past hospitalization rates each season to help inform current vaccination strategies and direct patient counseling and education efforts throughout the pharmacy. Pharmacists can easily monitor such data through the CDC’s RSV Hospitalization Surveillance Network.⁴

During the 2024-2025 season, hospitalizations peaked in January 2025, with a rate of 3.9 hospitalizations per 100,000 individuals during the week ending on January 4, 2025. Hospitalization rates remained high during February but then underwent a rapid decline, dropping to 0.3 hospitalizations per 100,000 by the last week of April. A spike was observed in adults 65 years and older, with rates of 8.8 hospitalizations per 100,000 during the same early January period.⁴

There are some notable differences when comparing these rates with the 2023-2024 season. Once again, a higher burden can be seen in the 2023-2024 season, with a rate of 4.5 hospitalizations per 100,000 individuals during the last week of December and a peak rate of 9.5 hospitalizations per 100,000 among those 65 years and older. However, although hospitalization rates significantly receded by the end of April in both seasons, there was a more rapid decline in the 2023-2024 season compared with 2024-2025. From this data, pharmacists can gain a better grasp on when to expect severe RSV cases that could lead to hospitalizations and prepare not only vaccinations to offer patients but also treatment regimens for patients recovering from potentially serious RSV infections.⁴

Vaccination Rates Remain Suboptimal

Ultimately, vaccination is one of the most important tools in the arsenal of pharmacists and health care professionals to prevent serious disease. With RSV vaccines becoming available in 2023, data from the past 2 respiratory seasons are critical to evaluate and improve vaccination strategy and target education to specific populations. Using the CDC’s Weekly RSV Vaccination Dashboard, in-season RSV vaccination data can be gathered and analyzed for key trends.⁵

By the end of the 2024-2025 respiratory season, an estimated 47.5% of adults aged 75 and older (95% CI, 45.9%–49.1%) had reported ever receiving an RSV vaccine, whereas 8.0% (95% CI, 3.3%–12.8%) said they would definitely receive a vaccine, according to data from the CDC’s National Immunization Survey. For individuals aged 60 through 74 years, 38.1% (95% CI, 35.7%–40.4%) reported ever receiving an RSV vaccine, whereas 10.1% (95% CI, 5.0%–15.2%) reported that they definitely would receive a vaccine.⁵

There are also resources available to track how many vaccine doses have been administered in a given season. For the 2024-2025 season, the CDC estimated that around 1.76 million doses of RSV vaccine were administered to adults 75 years and older in retail pharmacies, cumulating in 6.26 million total doses, whereas 55,010 were given in physicians’ offices, totaling 145,350 cumulative doses in that setting. For adults aged 60 through 74 years, 1.62 million RSV vaccine doses were administered in retail pharmacies, totaling 7.84 million total doses, whereas 108,874 were administered in physicians’ offices, totaling 409,039 doses in that setting.^6,7

Leveraging Data for Novel Vaccination Strategies

Although the total number of vaccine doses administered was lower in 2024-2025 than in 2023-2024, the percentage of those at the highest risk for severe disease receiving a vaccine continues to increase, reflecting positive gains in RSV vaccination coverage. However, vaccine rates remain underwhelming compared with optimal goals, and more work needs to be done to increase uptake among those most vulnerable to severe disease.

The data from the 2024-2025 season clearly indicate that the RSV vaccines are successful at reducing the burden of illness and hospitalization. The significant number of vaccines administered in retail pharmacies showcases the major role pharmacies play in not only counseling patients on the benefits of vaccination and informing them about their options but also in administering vaccines and protecting patients. Additionally, the spike observed in RSV infections and hospitalizations during the winter months could be used as an opportunity to increase emphasis on vaccination before indoor gatherings begin to spread infections.

Pharmacists will continue to play an integral role in encouraging RSV vaccination during the upcoming respiratory season and beyond.

REFERENCES
1. Vaccination trends. CDC. Updated November 21, 2025. Accessed September 8, 2025. https://www.cdc.gov/respiratory-viruses/data/vaccination-trends.html

2. Vaccines for adults. CDC. Updated July 8, 2025. Accessed September 8, 2025. https://www.cdc.gov/rsv/vaccines/adults.html

3. The National Respiratory and Enteric Virus Surveillance System (NREVSS). CDC. Updated June 18, 2025. Accessed September 8, 2025. https://www.cdc.gov/nrevss/php/dashboard/index.html

4. RSV-NET. CDC. Updated June 5, 2025. Accessed September 8, 2025. https://www.cdc.gov/rsv/php/surveillance/rsv-net.html

5. Weekly RSV vaccination dashboard. CDC. Updated May 7, 2025. Accessed September 8, 2025. https://www.cdc.gov/rsvvaxview/dashboard/index.html

6. Respiratory syncytial virus (RSV) vaccinations administered in pharmacies and physician medical offices, adults, United States. CDC. Updated May 7, 2025. Accessed September 8, 2025. https://www.cdc.gov/rsvvaxview/dashboard/adult-vaccinations-administered.html

7. 2023-24 respiratory syncytial virus (RSV) vaccinations administered in pharmacies and physician medical offices (IQVIA), adults 60 years and older. CDC. Updated September 25, 2024. Accessed September 8, 2025. https://www.cdc.gov/rsvvaxview/dashboard/2023-24-adult-vaccinations-administered.html