The RSV vaccine is recommended for all adults 75 and older. Adults aged 50 to 74 can also get it if they have certain health conditions that raise their risk of severe RSV illness. Pregnant individuals have a separate recommendation, and infants are protected through a different type of immunization. Here’s how the age requirements break down for each group.
Adults 75 and Older
If you’re 75 or older, the CDC recommends a single dose of the RSV vaccine, no questions asked. You don’t need to have any specific health conditions or risk factors. This is a straightforward, universal recommendation for this age group.
Adults 50 to 74 With Risk Factors
If you’re between 50 and 74, you’re eligible for the RSV vaccine if you have at least one condition that increases your risk of severe illness. The qualifying conditions include:
- Chronic heart disease such as heart failure or coronary artery disease (high blood pressure alone doesn’t count)
- Chronic lung disease including COPD, emphysema, asthma, or cystic fibrosis
- Kidney disease requiring dialysis or other replacement therapy
- Complicated diabetes that has caused kidney damage, nerve damage, or eye damage, or that requires insulin
- Neurological conditions that weaken the ability to cough or breathe effectively
- Chronic liver disease such as cirrhosis
- Severe obesity with a BMI of 40 or higher
- A weakened immune system from a condition or medication
- Living in a nursing home
You don’t need to bring medical records to prove you have one of these conditions. The CDC’s guidance states that simply telling your provider you have a risk factor is sufficient, and vaccinators should not deny the shot for lack of documentation.
This policy replaced an earlier “shared clinical decision-making” approach, which left the choice up to individual conversations between patients and providers. The updated guidelines are more direct: if you’re 60 to 74 without any risk factors, RSV vaccination is no longer recommended for you. If you do have a qualifying condition, you should get it.
Under 50 Without Pregnancy
The CDC does not currently recommend RSV vaccination for most adults under 50. However, one of the FDA-approved vaccines (Arexvy) carries approval for adults 18 through 59 who are at increased risk of severe RSV-related lung disease. In practice, the CDC’s recommendations drive most insurance coverage and clinical decisions, so adults under 50 would need to discuss eligibility with a provider on a case-by-case basis.
Pregnant Individuals
Pregnant people have a narrow window for RSV vaccination: between 32 weeks and 36 weeks, 6 days of pregnancy. The vaccine (Abrysvo, made by Pfizer) prompts the body to produce protective antibodies that cross the placenta and shield the baby from RSV during the first months of life. Getting vaccinated after 36 weeks and 6 days isn’t recommended because there may not be enough time for antibodies to transfer to the baby before delivery.
This is not a vaccine for the pregnant person’s own protection. The entire purpose is to give the newborn a head start against RSV during their most vulnerable period.
Infants and Young Children
Babies don’t receive a traditional RSV vaccine. Instead, they get a preventive antibody treatment called nirsevimab, which works differently. Rather than training the immune system to make its own antibodies (as a vaccine does), it delivers ready-made antibodies directly.
This treatment is recommended for all infants younger than 8 months who are born during or entering their first RSV season, which typically runs from fall through spring. Babies whose mothers received the RSV vaccine during pregnancy generally don’t need it, since they already carry protective antibodies.
For children between 8 and 19 months old, nirsevimab is only recommended if they have specific high-risk conditions going into their second RSV season. These include chronic lung disease from premature birth that required ongoing treatment, severe immune compromise, cystic fibrosis with significant lung involvement or low weight, or being American Indian or Alaska Native. The CDC does not recommend nirsevimab for anyone 20 months or older.
How Many Doses You Need
For adults, the RSV vaccine is a single dose. It is not currently recommended as an annual shot like the flu vaccine. This makes it simpler than many other immunizations, though future guidance on boosters could change as more long-term data becomes available.
Cost and Insurance Coverage
If you have Medicare Part D, the RSV vaccine is covered at no cost to you. Medicare drug coverage includes all vaccines recommended by the CDC’s Advisory Committee on Immunization Practices, and RSV is on that list. Medicare Advantage plans that include drug coverage also cover it. For those with private insurance, coverage typically follows CDC recommendations, meaning you should be covered if you fall within the recommended age and risk groups.