Pharmacies are preparing for another cold and flu season involving respiratory syncytial virus (RSV).
RSV leads to common cold symptoms (fever sneezing, coughing, etc).
But infants and older adults can have severe breathing complications that may require hospitalization and even ICU care.
If your pharmacy administers RSV vaccines, differentiate product options and prevent vaccine errors to help protect patients.
Unvaccinated older adults should be immunized if they are 75 years and up...or 50 to 74 years with certain risk factors (diabetes, etc).
These patients can get any of the adult RSV vaccines...Abrysvo, Arexvy, or mResvia...in late summer or early fall depending on when your local RSV season starts. Compare products with our RSV Vaccines chart.
Be aware that FDA approved Abrysvo and mResvia for high-risk adults between 18 and 49 years. But the Advisory Committee on Immunization Practices doesn’t recommend routine RSV vaccination for these patients until we have more safety and effectiveness data.
Unvaccinated pregnant patients should get Abrysvo between 32 and 36 weeks of pregnancy...between September and January...to pass on RSV antibodies to their newborn.
Keep in mind that Arexvy and mResvia are NOT approved in pregnancy.
Highlight product differences to avoid storage and handling errors.
For example, point out that Abrysvo and Arexvy are refrigerated...while mResvia is frozen. And only Abrysvo and Arexvy are reconstituted.
Watch for Abrysvo product changes. The vial and diluent syringe kits are being phased out. This season, expect to only get the dual-chamber Act-O-Vial version that mixes drug and diluent when activated.
Limit confusion by ideally stocking the fewest product options needed to cover your patient population. For example, consider prioritizing Abrysvo if you serve both pregnant and older adults.
Know that most patients should only get 1 lifetime RSV vaccine dose for now until we have more study data. Update immunization histories in patient profiles to help ensure patients don’t get extra doses.
Use our Preventing RSV chart for more background about RSV risk factors, who should get a vaccine, and products for infants.
- CDC. RSV Vaccine Guidance for Adults. July 8, 2025. https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/adults.html (Accessed September 16, 2025).
- The American College of Obstetricians and Gynecologists. Maternal Respiratory Syncytial Virus Vaccination. August 2025. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2023/09/maternal-respiratory-syncytial-virus-vaccination (Accessed September 16, 2025).
- Chart: Preventing RSV
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Chart:
RSV Vaccines