RSV Vaccines: Efficacy, Options, and Your Role as a Pharmacist

Respiratory syncytial virus (RSV) infects the lungs and respiratory tract. Certain populations are more vulnerable to this virus, including children, older adults, patients with weakened immune systems, and those with heart or lung diseases.¹ Globally, RSV causes around 3.6 million hospitalizations and 100,000 deaths in children younger than 5 years annually.² In the US, RSV results in approximately 160,000 hospitalizations and 10,000 deaths in adults 65 years or older during the typical respiratory season.²

RSV belongs to 2 genotypes—A and B—and is a member of the Pneumoviridae and human metapneumovirus families. It is a messenger RNA (mRNA) virus that infects cells along the respiratory tract from the nose to the lungs. Infants, primarily those younger than 6 months, are at highest risk of severe RSV disease and death.²

RSV Vaccines: What You Need to Know

There are several vaccines in the market today for RSV prevention, as well as a preventive antibody treatment. Nirsevimab-alip (Beyfortus; Sanofi) is a monoclonal antibody injection with anti-RSV activity. It is indicated for neonates and infants born during or at the beginning of the RSV season, as well as children up to 24 months who are at high risk for severe RSV disease through their second RSV season.³

For older adults, 3 vaccines are available: mResvia (Moderna), Arexvy (GSK), and Abrysvo (Pfizer). According to the CDC, all 3 vaccines are recommended for unvaccinated individuals 75 years or older, and for those aged 50 to 74 years who are previously unvaccinated and at increased risk of severe RSV.⁴ mResvia contains a modified mRNA encoding RSV F glycoprotein, based on the RSV-A subtype and stabilized in a pre-F protein. Arexvy has a recombinant RSV F protein antigen specific to the RSV-A subtype. This is stabilized in a prefusion complex (preF) and the AS01_E adjuvant. Abrysvo also has a recombinant RSV F protein antigen and is stabilized in preF.⁴ Of the 3 vaccines, only Abrysvo can be given to pregnant patients at 32 to 36 weeks of gestation.⁵

The real-world effectiveness of the RSV vaccine in older adults is evident. A case-control study examined approximately 7000 adults 60 years and older who had been hospitalized with respiratory illness in specific hospital settings.⁶ It was found that, in general, a single RSV vaccine decreased the risk of hospitalization or serious illness due to RSV by 58%. RSV vaccination decreased the risk of severe outcomes such as respiratory failure, intensive care unit (ICU) admissions, and death by 70%.

Could RSV Vaccines Prevent Dementia?

In addition to preventing RSV, vaccination may have other benefits. A retrospective cohort study including more than 130,000 individuals in the US showed Arexvy is linked to reduced risk of dementia compared with the influenza vaccine. Those who received the RSV vaccine had a 29% reduction in dementia risk compared with those receiving the influenza vaccine due to the AS01 adjuvant seen in Arexvy, which plays a direct role in lowering dementia risk. The exact mechanism of the AS01 adjuvant in protecting against dementia remains unclear.⁷

Clinical Takeaways

It is vital that pharmacists explain the importance of getting the RSV vaccine to older adult patients. Pharmacists can give a brief overview of the statistics associated with hospitalizations and deaths related to RSV. Pharmacists are crucial partners in informing the general public of the reduction in serious clinical outcomes—ICU admissions, respiratory failure, and death—with RSV vaccinations. Pharmacists can also educate patients about studies showing the reduced risk of dementia, encouraging them to acknowledge the seriousness of RSV and other alternative benefits of receiving the vaccine.

REFERENCES

1. Fischer K. RSV (respiratory syncytial virus) vaccines. WebMD. May 21, 2024. Accessed March 4, 2026. https://www.webmd.com/lung/rsv-vaccines

2. Respiratory syncytial virus (RSV). World Health Organization. December 19, 2025. Accessed March 4, 2026. https://www.who.int/news-room/fact-sheets/detail/respiratory-syncytial-virus-(rsv)

3. Beyfortus. Prescribing information. Sanofi; 2024. Accessed March 4, 2026. https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/761328s005lbl.pdf

4. Respiratory syncytial virus (RSV) immunization: information for health care providers. CDC. September 4, 2024. Accessed March 4, 2026. https://www.cdc.gov/vaccines/hcp/by-disease/rsv.html?CDC_AA_refVal=

5. What you need to know about RSV vaccine: Abrysvo (Pfizer). CDC. Accessed March 4, 2026. https://www.cdc.gov/vaccines/vpd/rsv/downloads/357088-B_FS_ABRYSVO_508-04302025.pdf

6. Older adults found to gain major health benefits from RSV vaccine. Montefiore Einstein. September 16, 2025. Accessed March 4, 2026. https://montefioreeinstein.org/news/2025/09/16/older-adults-found-gain-major-health-benefits-rsv-vaccine

7. Cassella C. Huge study reveals 2 vaccines that appear to reduce dementia risk. ScienceAlert. July 21, 2025. Accessed March 4, 2026. https://www.sciencealert.com/huge-study-reveals-2-vaccines-that-appear-to-reduce-dementia-risk