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Respiratory syncytial virus (RSV) vaccine - RSV vaccine information for health professionals

Background

Respiratory syncytial virus (RSV) is a common cause of respiratory tract infections. While RSV infections can occur year-round, they are most prevalent in autumn and winter.  

RSV infection typically causes cold-like symptoms, including:  

  • rhinitis  
  • cough  
  • shortness of breath  
  • wheeze 
  • lethargy   
  • fever (sometimes)     

RSV spreads from respiratory secretions through close contact with an infected person via respiratory droplets or contact with contaminated surfaces or objects. The virus can survive on surfaces or objects for about four to seven hours. The incubation period ranges from two to eight days, and the infectious period lasts from three to eight days. 

RSV infection is usually mild and resolves by itself. However, infants and older adults are at higher risk of acute lower respiratory tract infection (LRTIs). In all ages, LRTIs can include pneumonia. In infants, it can lead to bronchiolitis, which can make it difficult to breathe and feed and may cause decreased oral intake. Additionally, RSV can cause croup and otitis media in children.  

Globally, RSV infects up to 90% of children within the first two years of life and frequently reinfects older children and adults.

RSV LRTIs significantly impact immunocompromised and older adults. It can manifest as exacerbations of underlying chronic obstructive pulmonary disease (COPD) or cardiovascular disease. As adults get older, the immune system weakens (immunosenescence), which may increase the risk of severe RSV infection. 

Most RSV hospital admissions involve infants born at full term without underlying risk factors. Infants born prematurely and those born between August and November are at greater risk of hospitalisation with RSV during autumn and winter months. 

Predisposing clinical risk factors for severe RSV disease in infants include: 

  • congenital heart disease 
  • chronic lung disease 
  • chromosomal abnormalities 
  • neuromuscular disorders 
  • large airway abnormalities, and 
  • immunodeficiency (especially those with multiple health conditions). 

Joint Committee on Vaccination and Immunisation (JCVI) guidance  

In 2023, the JCVI acknowledged the significant impact of RSV on the UK population and the strain it places on NHS services during winter. The JCVI advised RSV vaccination programmes to protect infants and older adults. In June 2024, the Welsh Government accepted the advice and the vaccine programmes commenced on 1 September 2024.  

The JCVI uses emerging evidence to inform its advice on expanding the vaccination programme. More information can be found on the Joint Committee on Vaccination and Immunisation GOV.UK (external site) website.

Older adults programme 

The following older adults are eligible for the RSV vaccination: 

The older adult RSV vaccination programme is a year-round programme. The recommended RSV immunisation schedule for older adults consists of a single dose given by intramuscular injection, preferably in the deltoid muscle. 

In 2026, a case-control study across the four UK nations was conducted. The results showed that RSVpreF vaccination was associated with a significant reduction in RSV-related hospitalisation among older adults, with a pooled vaccine effectiveness estimate of 75%. For further information, read the following article: Real-world evidence on RSV vaccine uptake, effectiveness, and safety in older adults: a systematic review and meta-analysis – The Lancet Regional Health – Europe (external site) 

Ensure arrangements are in place to vaccinate residents of older adult care homes as they become eligible, including outside other seasonal programmes (e.g. COVID-19).  

Where appropriate, consider co-administering the RSV vaccine with other vaccines that the individual may be eligible for, including COVID-19, shingles and pneumococcal vaccines. 

Maternal programme for infant protection 

The maternal programme for infant protection should be offered to: 

  • All pregnant women from 28 weeks’ gestation.  

Pregnant women remain eligible for vaccination until discharge from maternity services, although timely vaccination from 28 weeks is recommended. This allows sufficient time for the mother to make high levels of antibodies, which then transfer across the placenta. This also increases the potential that infants born prematurely will benefit.  

Maternal vaccination has shown to be effective against RSV LRTI in infants from birth to beyond six months. A study showed up to an 81% reduction in hospital admissions in newborns when mothers were vaccinated at least 14 days before birth. For further information, read the following article: Effectiveness of the maternal RSVpreF vaccine against severe disease in infants in Scotland, UK: a national, population-based case–control study and cohort analysis – The Lancet Infectious Diseases (external site) 

The vaccine can be offered off-label after 36 weeks gestation, but this may not offer as high level of passive protection to the baby. For women not vaccinated during pregnancy, vaccination can be offered after delivery before they are discharged from maternity services. Vaccination post-delivery does not offer transplacental antibody transfer and therefore does not provide passive protection to the infant. However, it may protect the mother from contracting RSV or make her less infectious. Antibodies may also transfer to the infant from breastmilk.    

Vaccination should be offered in every pregnancy to protect each infant against RSV. 

Information:

It is important that pregnant women have their vaccines at the right time in pregnancy. Pregnant women should receive their vaccines as soon as they become eligible.   

It is important that pregnant women have their vaccines at the right time in pregnancy. Pregnant women should receive their vaccines as soon as they become eligible.    

The vaccine 

The vaccine used in Wales is Abrysvo®.  

New medicines and vaccines that are under additional monitoring have an inverted black triangle symbol (▼) displayed in their package leaflet and summary of product characteristics, together with a short sentence explaining what the triangle means. You should report all suspected adverse reactions for these products.  

Reporting suspected adverse reactions after vaccination is important. It helps monitor the safety and benefits of the medicine. You should report suspected adverse reactions of vaccines and medicines online at Yellow Card (external site), by downloading the Yellow Card app, or by calling 0800 731 6789 (Monday to Friday, 9am to 5pm).  

More information about the vaccine can be found in the Green Book: Respiratory syncytial virus chapter (external site) 

Vaccine co-administration in older adults 
Vaccines commonly administered to older adults  Can they be administered together? 
Abrysvo® and Shingrix®   ✔ 
Abrysvo® and Prevenar 20 and/or Pneumovax 23®  ✔ 
Abrysvo® and COVID-19 vaccine   ✔
Abrysvo® and influenza vaccine   ✔* 

*Abrysvo® should not be routinely scheduled on the same day as the influenza vaccine in older adults. Giving Abrysvo® with the seasonal influenza vaccine may reduce the immune response to both the RSV and influenza (H3N2) components, which may increase the risk of severe respiratory disease in older adults. However, if it is thought that the individual is unlikely to return for their influenza vaccine, they can be given at the same time.    

The side effects from vaccines given together are expected to be similar to the side effects of each vaccine when given alone.   

For further information about vaccine co-administration with Abrysvo®, see the Green Book: Respiratory syncytial virus chapter (external site) 

Vaccine co-administration in pregnant women  
Vaccines Can they be administered together? 
Abrysvo® and anti-D immunoglobulin ✔ 
Abrysvo® and pertussis-containing vaccine ✔* 
Abrysvo® and seasonal influenza vaccine ✔ 

* There is some evidence that giving the RSV vaccine with pertussis-containing vaccines may slightly reduce the immune response to pertussis. The clinical impact is unclear and likely small. To avoid this potential issue, it is recommended to administer the vaccines separately, with the pertussis vaccine given from 16 weeks and the RSV vaccine from 28 weeks. However, if a woman has not received the pertussis vaccine when she is due for the Abrysvo® RSV vaccine, both vaccines can and should be given at the same appointment to ensure timely protection for the infant.  

For pregnant women who are eligible to receive COVID-19 vaccine during a vaccination campaign, this can be given at the same time as the RSV vaccine.  

The side effects from vaccines given together are expected to be similar to the side effects of each vaccine when given alone.  

For further information about vaccine co-administration with Abrysvo®, see the Green Book: Respiratory syncytial virus chapter (external site).

Guidance

Vaccination programme recommendations from the JCVI and Welsh Government policy can be found at the links below.  

Joint Committee on Vaccination and Immunisation (external site) – read JCVI publications and statements; search e.g., ‘Respiratory Syncytial Virus’, ‘RSV’. 

Welsh Health Circulars and Welsh Government letters 

The Complete Routine Immunisation Schedule for Wales includes information about routine and non-routine vaccinations. 

Training resources and events 

Online courses and training materials can be accessed via the E-learning page. 

Further immunisation training information and resources are provided on the Training Resources and Events page. 

RSV clinical resources and information

Maternal and older adult programmes 

Maternal vaccination programme resources 

Older adult routine programme resources 

Patient group directions (PGDs) and vaccine group directions (VGDs) 

PGD and VGD templates for vaccines can be found on the Welsh Medicines Advice Service (external site).

More information

Page last reviewed: 1st September 2026