Ask the Experts: Respiratory syncytial virus (RSV): Vaccine Recommendations during Pregnancy

Results (6)

Pregnant people between 32 and 36 weeks and 6 days’ gestation during the months of September through January in the United States should get one dose of the Pfizer RSVpreF vaccine (Abrysvo) to protect their babies during their first RSV season after birth. Only Abrysvo is FDA-approved and recommended for pregnant people. Arexvy (by GSK) is not approved and should not be given during pregnancy.

In most of the continental United States, maternal RSV vaccine is recommended only September through January. Those who provide health care to pregnant people who live in areas with different patterns of RSV seasonality, such as Alaska, Hawaii, parts of Florida, or other jurisdictions outside the continental United States, should follow guidance from local or regional public health authorities about the timing of RSV vaccination during pregnancy in their regions.

Last reviewed: January 22, 2024

No. Only the Pfizer (Abrysvo) RSV vaccine is recommended for pregnant people. The GSK RSV vaccine (Arexvy) is not licensed or recommended for use in pregnancy.

If Arexvy is inadvertently administered during pregnancy, do NOT administer a dose of Abrysvo. Instead, CDC recommends that the infant (if younger than 8 months) should receive nirsevimab during RSV season (October through March in most of the continental United States). Treat the infant in the same manner as an infant born to a mother who did not receive RSV vaccination during pregnancy.

CDC strongly urges that this type of administration error be reported to the Vaccine Adverse Event Reporting System, VAERS (https://vaers.hhs.gov). Prevent administration errors with health care provider training on the different indications for each RSV prevention product (both vaccines and the nirsevimab preventive antibody for infants), and always check product labels at least three times before administration to verify that the correct product is being administered to the patient. Consider implementing other feasible safeguards in your system (e.g., electronic alerts) to prevent such errors.

For additional information about this type of error, see the CDC Clinician Outreach and Communication Activity (COCA) Now update from January 22, 2024:  https://emergency.cdc.gov/newsletters/coca/2024/012224.html

Last reviewed: January 22, 2024

No. RSV vaccination during pregnancy is only recommended for pregnant people who are at the recommended stage of pregnancy (32 weeks through 36 weeks 6 days’ gestation) during the recommended time of year (typically September through January). In regions with seasonal patterns of RSV that differ from the continental United States, such as Alaska, Hawaii, or subtropical parts of Florida, follow local public health or health care guidance on timing, which may differ.

Last reviewed: January 22, 2024

Yes. Pfizer’s RSV vaccine (Abrysvo) may be administered from 32 weeks through 36 weeks and 6 days’ gestation. RSV vaccine should not be administered to someone at 37 weeks’ gestation or beyond.

RSV vaccine should be administered at least 2 weeks before delivery to allow time for the maternal immune system to create antibodies and transfer sufficient antibodies to the fetus for adequate protection after birth. If the gestational age is appropriate, but clinical judgment is that delivery is likely to occur within 2 weeks, it is reasonable to defer vaccination and plan to administer nirsevimab RSV preventive antibody to the infant after delivery. Infants born less than 14 days after maternal RSV vaccination are recommended to receive nirsevimab RSV preventive antibody after birth to ensure adequate protection.

Last reviewed: January 22, 2024

Many pregnant people will have a choice about whether to get Abrysvo during pregnancy or to give nirsevimab to their infant after birth. Those who are between 32 and 36 weeks 6 days’ gestation between September and January, may be vaccinated with Abrysvo or have their infant receive nirsevimab soon after birth (preferably within the first week of life if born during a month when nirsevimab administration is recommended).

It is important to note that both Abrysvo RSV vaccine and nirsevimab products may not be available to all people in all settings. In some facilities or circumstances, only one option might be available: those offered Abrysvo during pregnancy may not wish to defer that option unless they are confident that nirsevimab will be available for their infant. All infants up to 8 months 0 days of age whose mothers were not vaccinated may be given nirsevimab when feasible, before or during their first RSV season.

Last reviewed: January 22, 2024

Yes. VFC-eligible pregnant adolescents younger than age 19 may receive VFC-funded Abrysvo during pregnancy, if indicated, in VFC-participating facilities. Contact your state immunization program with questions about VFC and Abrysvo.

Last reviewed: January 22, 2024

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