Adults 75 and Older Need Only One RSV Shot for Now: What New 2026 Guidance Means

The main message for older adults in 2026 is straightforward: if you are 75 or older and have never received an RSV vaccine, current U.S. guidance says you should get one dose. If you already received an RSV shot in a prior season, you are not advised to get another dose right now.

That is an important point because RSV vaccination is not an annual shot at this time. It is a single dose for now, while health officials continue studying how long protection lasts and whether repeat doses may ever be needed in the future.

Why RSV matters more in older adults

RSV, or respiratory syncytial virus, often starts like a bad cold. It can cause cough, congestion, fatigue, fever, and wheezing. In older adults, though, it can move deeper into the lungs and lead to serious lower respiratory illness, pneumonia, hospitalization, and sometimes death.

The risk is highest in adults 75 and older, especially those who also have chronic heart or lung disease, kidney disease, diabetes with complications, weakened immunity, frailty, or who live in a nursing home or other long-term care setting.

That is why the CDC now gives a clear age-based recommendation for everyone 75 and older, instead of leaving the decision only to individual risk discussions.

What the 2026 guidance says

The CDC’s current adult RSV guidance says all adults age 75 and older should receive a single RSV vaccine dose if they have not already been vaccinated. The American College of Physicians reinforced that message in March 2026 with updated practice points for physicians.

Just as important is what the guidance does not say:

It does not call for an RSV shot every year.
It does not tell people who already had one RSV shot to get another dose now.
It does not name one brand as best for older adults. The CDC says there is no preference among the licensed adult RSV vaccines.

If you are eligible and still unvaccinated, you can get the shot at any time of year. But the preferred window is late summer to early fall, usually August through October in most of the continental United States, so protection is in place before RSV season ramps up.

The CDC also says RSV vaccine can be given during the same visit as other adult vaccines. For some people, that may make it easier to stay up to date before fall.

Many eligible older adults still have not gotten it

This explainer is useful now because a large share of eligible older adults still appear to be unvaccinated. CDC RSVVaxView estimates from early 2026 suggest that only about 43% of adults 75 and older reported ever receiving an RSV vaccine. A separate CDC estimate based on Medicare fee-for-service claims found about 36.9% of Part D-enrolled beneficiaries age 75 and older had been vaccinated by the end of January 2026.

In other words, depending on the data source, well under half of the oldest eligible adults appear to have received the shot so far.

That matters most for people with the highest risk of severe illness, including those in long-term care, those with chronic medical conditions, and families caring for medically fragile older relatives.

Where to get the shot and what Medicare covers

For many older adults, the RSV shot is available at a local pharmacy, a doctor’s office, or another outpatient vaccination site.

Medicare access is also fairly simple, with one important detail: Medicare Part D covers the RSV shot with no cost sharing. That means people with Part D coverage should not pay out of pocket for the vaccine itself. If you are in a Medicare Advantage plan, drug coverage must be included for that Part D vaccine benefit to apply.

If you are not sure whether your plan includes Part D coverage, it is worth checking before your appointment. Pharmacies can often look this up for you.

What the evidence shows

The current recommendation is based on both clinical trial evidence and real-world studies.

Randomized trials in older adults showed that RSV vaccines reduced serious lower respiratory illness. A rapid evidence review published for the American College of Physicians in Annals of Internal Medicine concluded that protein-subunit RSV vaccines probably reduce RSV-related hospitalization and severe RSV illness in adults 60 and older.

Real-world evidence has added another useful piece. A study published in JAMA examined 6,958 hospitalized adults age 60 and older across 20 states over two RSV seasons. It found that a single RSV vaccine dose was associated with lower risk of RSV-related hospitalization across those two seasons. Protection appeared stronger when vaccination happened in the same season and lower when the dose came from a prior season, suggesting meaningful protection can extend beyond one year but may decline over time.

That helps explain why officials say the vaccine is not annual right now, while still stopping short of saying one dose will be enough forever.

What remains uncertain

The biggest open question is duration. Protection appears meaningful across at least two seasons in the available evidence, but some waning is expected, and health officials are still evaluating whether older adults might benefit from future repeat dosing.

There are other limits to keep in mind too. Some of the best early data studied adults 60 and older as a broad group, not only people 75 and older. And some real-world studies are observational, which means they can show strong associations in everyday care but are not as definitive as randomized trials.

Safety monitoring is also ongoing, as it is for all newer vaccines. That does not mean older adults should avoid vaccination, but it does mean guidance may continue to evolve as more seasons of data accumulate.

Symptoms to watch for and when to seek care

In older adults, RSV may begin with cold-like symptoms but can become more serious. Call a clinician promptly if an older adult with a respiratory illness develops worsening shortness of breath, wheezing, dehydration, unusual sleepiness, or trouble keeping up with normal activities. Seek urgent care for severe breathing trouble, bluish lips, chest pain, or new confusion.

What this means for readers

If you are 75 or older and have never had an RSV shot, ask your clinician or pharmacist about getting one before the next respiratory virus season.
If you already got an RSV vaccine in a prior season, current U.S. guidance does not recommend another dose right now.
If you live in long-term care or have heart, lung, kidney, diabetes-related, or immune-related health problems, you have extra reason to ask about RSV protection.
For many older adults, the shot is available at a pharmacy or doctor’s office and is covered under Medicare Part D.

The short version is this: one RSV shot for now, not every year, and especially worth discussing if you are 75 or older and still have not gotten it.

Sources

This article is for general informational purposes only and is not medical advice. Research findings can be early, limited, or subject to change as new evidence emerges. For personal guidance, diagnosis, or treatment, consult a licensed clinician. For current outbreak or public health guidance, follow your local health department, the CDC, or another relevant public health authority.