ACIP recommends use of either RSVpreF (Abrysvo, Pfizer) or RSVPreF3 (Arexvy, GSK) as a single dose in adults age 60 years and older, using shared clinical decision-making (SCDM). In SCDM-type recommendations, the choice to vaccinate is an option guided by a patient’s individual risk for severe disease and the patient’s values and preferences. SCDM also takes into account the provider’s clinical discretion concerning the patient and the vaccine.
ACIP recommends the following factors be considered during the shared clinical decision-making process: whether the patient has one or more risk factors for severe RSV disease; a patient’s risk of exposure to RSV (e.g., are they around young children, or living in a long-term care facility?); a patient’s preferences for RSV vaccination, including an understanding of safety, side effects, and costs; and the clinical discretion of the health-care provider.
The risk of hospitalization with RSV disease rises with increasing age after age 60. Other factors that increase risk are overall frailty, residence in a long-term care facility or nursing home, and one or more chronic medical conditions. A separate question provides details on risk factors.
CDC has developed a simple job aid for providers to assist in these discussions: www.cdc.gov/vaccines/vpd/rsv/downloads/provider-job-aid-for-older-adults-508.pdf.
See the full 2023 ACIP recommendation for older adults here: www.cdc.gov/mmwr/volumes/72/wr/mm7229a4.htm.