Updated RSV Guidance in 2026: Which Older Adults Should Get Vaccinated and Why

Bottom line: In 2026, U.S. guidance continues to recommend a one-time RSV vaccine for adults age 75 and older, and for adults ages 60 to 74 who have certain health conditions that increase their risk of severe disease. If you fall into one of these groups, vaccination can significantly reduce your chances of hospitalization from RSV.

Respiratory syncytial virus (RSV) is widely known as a threat to infants, but it also causes serious illness in older adults every year. Since RSV vaccines became available for adults, federal guidance has been refined to clarify exactly who benefits most.

What is RSV and why does it matter for older adults?

RSV is a common respiratory virus that spreads through droplets when people cough, sneeze, or talk. In healthy younger adults, it often feels like a mild cold. But in older adults — especially those with chronic medical conditions — it can lead to:

Pneumonia
Worsening of asthma or COPD
Heart failure flare-ups
Hospitalization
In rare cases, death

According to the Centers for Disease Control and Prevention (CDC), RSV leads to tens of thousands of hospitalizations among adults 65 and older in the United States each year. Risk increases with age and with underlying health problems.

What changed in RSV guidance heading into 2026?

CDC recommendations, based on guidance from the Advisory Committee on Immunization Practices (ACIP), now clearly divide older adults into two groups:

1. Adults age 75 and older

CDC recommends a single dose of RSV vaccine for everyone in this age group, regardless of other medical conditions.

The reason is straightforward: age alone significantly increases the risk of severe RSV disease. Immune responses weaken over time, and older lungs are more vulnerable to complications.

2. Adults ages 60 to 74 with higher risk

For this group, vaccination is recommended for those at increased risk of severe RSV. This includes people with:

Chronic heart disease
Chronic lung disease (including COPD and asthma)
Diabetes
Kidney or liver disease
Weakened immune systems
Severe obesity
Residence in long-term care facilities

In earlier guidance, RSV vaccination for adults 60 and older was based on shared decision-making. Updated recommendations focus more directly on people at highest risk, based on real-world effectiveness data from the first seasons of vaccine use.

How well do RSV vaccines work?

The original approvals of RSV vaccines were based on large randomized clinical trials involving thousands of adults age 60 and older. These trials showed strong protection against severe RSV-related lower respiratory tract disease during the first RSV season after vaccination.

Since rollout, real-world data collected by CDC and other public health systems suggest that the vaccines continue to reduce the risk of hospitalization, particularly in older adults and those with chronic conditions. Protection appears strongest in the first RSV season after vaccination.

At this time, RSV vaccination for older adults is considered a one-time dose. Federal health officials continue to monitor durability of protection to determine whether boosters may be needed in the future.

When should older adults get the RSV vaccine?

RSV season typically peaks in fall and winter, similar to flu season. CDC advises getting vaccinated in late summer or early fall, before RSV begins spreading widely in your community.

RSV vaccine can generally be given at the same visit as influenza and updated COVID-19 vaccines, though some people may choose to space them out to better manage short-term side effects like fatigue or sore arm.

What are the side effects?

In clinical trials and post-marketing monitoring, the most common side effects have included:

Sore arm
Fatigue
Headache
Muscle aches

These effects are usually mild and last one to two days.

As with all vaccines, CDC and FDA continue safety monitoring through systems such as VAERS (Vaccine Adverse Event Reporting System). Rare neurological conditions have been evaluated, but current evidence supports a favorable benefit–risk balance in recommended age groups.

Who may choose not to get it?

RSV vaccination is not recommended for adults under 60 at this time unless specific guidance changes. People who have had a severe allergic reaction to a previous RSV vaccine dose or a known component should not receive it.

If you are between 60 and 74 and healthy without chronic conditions, the decision may depend on your personal risk tolerance and discussion with your clinician.

What about people in nursing homes?

Residents of long-term care facilities are at particularly high risk of RSV outbreaks. Vaccination can reduce severe outcomes in these settings, where respiratory viruses spread quickly. Families with loved ones in nursing homes may want to ask facility staff about vaccination policies before RSV season.

Why this matters for families and caregivers

RSV does not just affect the individual. Severe infection can lead to hospitalization, temporary loss of independence, or long recovery periods. Caregivers often shoulder additional stress when older relatives become ill.

Vaccination is one tool — along with hand hygiene, staying home when sick, and good ventilation — that helps reduce community spread.

What this means for readers

If you are 75 or older, a one-time RSV vaccine is recommended.
If you are 60 to 74 and have chronic health conditions, vaccination is also recommended.
If you are healthy and under 75, talk with your clinician about your personal risk.
Plan vaccination before fall RSV season.

As with influenza and COVID-19, RSV risk rises with age. Updated 2026 guidance aims to focus protection where it is most likely to prevent hospitalizations and serious complications.

If you are unsure whether you qualify, your primary care clinician or pharmacist can review your medical history and help you decide.

Sources

https://www.cdc.gov/rsv/vaccines/older-adults.html

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.