ACP Advises All Adults 75 or Older Get a Protein Subunit RSV Vaccine

In this population, RSV vaccination has been shown to reduce severe illness, hospitalization, and death

PHILADELPHIA, March 3, 2026 – The American College of Physicians (ACP) issued updated vaccine practice points for physicians that advise adults aged 75 or older should receive a protein subunit Respiratory Syncytial Virus (RSV) vaccine and those aged 60-74 at increased risk for severe RSV may consider receiving the protein subunit RSV vaccine. “Respiratory Syncytial Virus Vaccines in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians” is published in Annals of Internal Medicine.  

Annually in the US, an estimated 170,000 adults aged 50 or older will be hospitalized and 14,000 deaths will occur due to RSV. Most adults infected by RSV have mild upper respiratory tract infections, but it can also cause life threatening lower respiratory tract infections. Among adults, severe RSV infection is more likely in those aged 75 or older, living in a long-term care facility or with a comorbid condition such as chronic kidney, liver, or lung disease, cardiovascular disease, hematologic conditions (such as sickle cell disease), diabetes, obesity, or a combination of these conditions. Unlike other respiratory virus vaccines that are administered annually, such as influenza, an RSV vaccine is administered only once, and the need for repeat vaccination is being studied.

The ACP Population Health and Medical Science Committee (PHMSC) developed the RSV practice points based on a rapid review by the ACP Center for Evidence Reviews. They addressed the efficacy, comparative effectiveness, and harms of RSV vaccines in adults aged 18 or older who were not pregnant or immunocompromised. 

The PHMSC considered evidence on benefits (all-cause mortality, reduced RSV-related hospitalization or severe illness) and harms (such as Guillain-Barre’ syndrome) and concluded that the benefits of the protein subunit vaccines outweigh the harms in adults aged 75 years or older. The benefits, such as prevention of hospitalization, is lower in adults aged 60-74 years compared to those 75 years or older but with the same harms.

“RSV can lead to severe complications, including hospitalization and even death, especially among older adults and people with underlying health conditions,” said Jason M. Goldman, MD, MACP, president of ACP. “We urge physicians to follow ACP’s RSV vaccine guidance to help ensure their patients receive safe, effective protection.”

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About the American College of Physicians
The American College of Physicians is the largest medical specialty organization in the United States with members in more than 172 countries worldwide. ACP membership includes 163,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on X, Facebook, Instagram, Threads, and LinkedIn, and subscribe to our RSS feed.

Contact: Lori Bookbinder, 215-351-2431, Lbookbinder@acponline.org