ACIP Votes to Expand Lowering RSV Vaccine Recommendation Age to 50 for High-Risk Adults

The CDC’s Advisory Committee on Immunization Practices (ACIP) voted unanimously (14-0) to expand its respiratory syncytial virus (RSV) vaccine recommendation to patients aged 50 to 59 years that are at an increased risk for RSV-associated lower respiratory tract disease (LRTD).¹

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“With its vote to expand adult RSV vaccination recommendations, ACIP has taken an important step toward protecting individuals aged 50 to 59 who have underlying medical conditions that increase their risk for severe RSV illness,” Alejandro Cane, vice president, vaccines and antivirals US medical lead from Pfizer, said in a news release.¹

ACIP’s expanded recommendation emphasizes the need for further protection among this age group, as between 15,000 and 20,000 adults aged 50 to 59 years are hospitalized due to RSV, according to the CDC. Adults in this population who have underlying medical conditions such as obesity, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), asthma, or other chronic or immunocompromising conditions face the highest risk for needing hospitalization from RSV.¹ Individuals infected with severe RSV typically present mild cold-like symptoms; however, in some cases hospitalization is needed. Additionally, RSV could worsen serious conditions such as asthma, COPD, and heart failure.²

Approved RSV Vaccines for Adults

Currently, the CDC recommends a single dose of any of the FDA-approved RSV vaccines—RSVPreF3 (Arexvy; GSK), RSVpreF (Abrysvo; Pfizer), and mRNA-1345 (mRESVIA; Moderna)—for all adults 75 years and older, along with individuals aged 60 to 74 years who are at increased risk of severe illness.³

Approved by the FDA in October 2024, Abrysvo is the only vaccine among the 3 approved that is indicated to protect adults aged 60 and older and adults 18 years and older at an increased risk of RSV-LRTD.⁴ Additionally, the FDA approved Arexvy for use in adults aged 50 to 59 years who are at increased risk for RSV-LRTD in June 2024.⁵

Previous ACIP Vote and Current Recommendation

In June 2024, ACIP voted in favor of recommending the routine use of RSV vaccines in all adults aged 75 years and older, along with individuals aged 60 to 74 years who are at increased risk for severe RSV disease. At the time of this recommendation, the vote to expand its use to high-risk individuals aged 50 to 59 years was postponed, highlighting this current development.⁶

Despite ACIP's change from the previous recommendation to lower the age for RSV vaccination to 50 from 60 for adults at high risk, the expansion is currently awaiting final approval from the director of the CDC and the Department of Health and Human Services. Additionally, the recommendations are not considered final until they are published in the Morbidity and Mortality Weekly Report.¹

REFERENCES

1. ACIP Votes to Expand Recommendation for Pfizer’s RSV Vaccine ABRYSVO® to Include Adults Aged 50 to 59 at Increased Risk of Disease. Pfizer. News release. April 16, 2025. Accessed April 17, 2025. https://www.pfizer.com/news/press-release/press-release-detail/acip-votes-expand-recommendation-pfizers-rsv-vaccine

2. RSV in Older Adults. CDC. News release. August 30, 2024. Accessed April 17, 2025. https://www.cdc.gov/rsv/older-adults/index.html.

3. RSV Vaccines. CDC. News release. August 30, 2024. Accessed April 17, 2025. https://www.cdc.gov/rsv/vaccines/index.html

4. Ferrugia K. FDA Approves Abrysvo to Treat Adults 18 to 59 Years of Age at Increased Risk for RSV. Pharmacy Times. October 23, 2025. Accessed April 17, 2025. https://www.pharmacytimes.com/view/fda-approves-abrysvo-to-treat-adults-18-to-59-years-of-age-at-increased-risk-for-rsv

5. McGovern G. FDA Approves Expanded Age Indication for Arexvy RSV Vaccine. Pharmacy Times. June 10, 2024. Accessed April 17, 2025. https://www.pharmacytimes.com/view/fda-approves-expanded-age-indication-for-arexvy-rsv-vaccine

6. Ferruggia K. ACIP Releases Updated RSV Recommendations. Pharmacy Times. July 5, 2024. Accessed April 17, 2025. https://www.pharmacytimes.com/view/acip-releases-updated-rsv-recommendations