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Respiratory syncytial virus (RSV) vaccine - RSV vaccine information for health professionals

Background

Respiratory Syncytial Virus (RSV) is one of the common viruses responsible for respiratory tract infections. While RSV infections can occur year-round, they are most prevalent in autumn and winter. 

RSV infection causes symptoms like those of a cold, including: 

  • rhinitis (runny nose, sneezing or nasal congestion) 
  • cough 
  • shortness of breath 
  • wheezing 
  • lethargy, and  
  • fever (sometimes).    

RSV spreads from respiratory secretions through close contact with an infected person via respiratory droplets or contact with contaminated surfaces or objects. The virus can survive on surfaces or objects for about four to seven hours. The incubation period ranges from two to eight days, and the infectious period lasts from three to eight days. 

RSV infection is usually mild and resolves by itself. However, infants and older adults are at higher risk of acute lower respiratory tract infection (LRTIs). In all ages, LRTIs can include pneumonia. In infants, it can lead to bronchiolitis, which can make it difficult to breathe and feed and may cause decreased oral intake. Additionally, RSV can cause croup and otitis media in children.  

Globally, RSV infects up to 90% of children within the first two years of life and frequently reinfects older children and adults.

RSV maternal programme for infants

Most RSV hospital admissions involve infants born at full term without underlying risk factors. Infants born prematurely and those born between August and November are at greater risk of hospitalisation with RSV during autumn and winter months.

Predisposing clinical risk factors for severe RSV disease in infants include:

  • congenital heart disease
  • chronic lung disease
  • chromosomal abnormalities
  • neuromuscular disorders
  • large airway abnormalities, and
  • immunodeficiency (especially those with multiple health conditions).
RSV programme for older adults

RSV LRTIs significantly impact immunocompromised and older adults. It can manifest as exacerbations of underlying chronic obstructive pulmonary disease (COPD) or heart disease. As adults get older, the immune system weakens (immunosenescence). This may increase the risk of severe RSV infection.

JCVI guidance 

The Joint Committee on Vaccination and Immunisation (JCVI) acknowledges the significant impact of RSV on the UK population and the strain it places on NHS services during winter.  

In 2023, the JCVI recommended implementing RSV immunisation programmes to protect infants and older adults as the most vulnerable groups to this infection.   

From 1 September 2024, Wales introduced: 

  • a maternal programme to protect infants, and  
  • an older adult programme to protect older adults.  

The older adult programme included a single dose for adults turning 75 years of age with a one-off, single-dose catch-up campaign for 75 to 79 year olds. 

In July 2025, JCVI issued further advice that the catch-up campaign for older adults should be extended to include: 

  • all adults aged 80 years and over, and  
  • all residents of care homes for older adults. 

Read the RSV immunisation programme for adults aged 80 years and older: JCVI advice July 2025 for more information. 

The vaccine 

The vaccine used in both the maternal programme and the older adult programme is Abrysvo®. 

New medicines and vaccines that are under additional monitoring have an inverted black triangle symbol (▼) displayed in their package leaflet and summary of product characteristics, together with a short sentence explaining what the triangle means. You should report all suspected adverse reactions for these products. 

Reporting suspected adverse reactions after vaccination is important. It helps monitor the safety and benefits of the medicine. You should report suspected adverse reactions of vaccines and medicines online at Yellow Card, by downloading the Yellow Card app, or by calling 0800 731 6789 (Monday to Friday, 9am to 5pm). 

More information about the vaccine can be found in Respiratory syncytial virus: the green book.

Guidance in the RSV Green Book Chapter supersedes the SmPC

The Complete Routine Immunisation Schedule for Wales includes information about routine and non-routine vaccinations.  

Maternal RSV programme for infants   

The RSV vaccine is offered routinely to all pregnant women from 28 weeks gestation. The vaccine is offered year-round, and vaccination is recommended in every pregnancy.  

Ideally the vaccine should be given in week 28 or soon after. This allows sufficient time for the mother to make high levels of antibodies, which then transfers across the placenta. This also increases the potential that infants born prematurely will benefit. The vaccine can be offered off-label after 36 weeks gestation, however this may not offer as high level of passive protection to the baby.   

For women not vaccinated during pregnancy, vaccination can be offered after delivery before they are discharged from maternity services. However, vaccination post-delivery does not offer transplacental antibody transfer and therefore does not provide passive protection to the infant. It may however protect the mother from contracting RSV or make her less infectious, and antibodies may also transfer to the infant from breastmilk.   

Maternal vaccination has shown to be effective against RSV LRTI in infants from birth to beyond six months. A trial showed that vaccinating pregnant women between weeks 24 and 36 significantly reduced RSV LRTI and severe RSV LRTI in infants.  

It is important that pregnant women have their vaccines at the right time in pregnancy. Pregnant women should receive their vaccines as soon as they become eligible.   

Vaccinations in pregnancy
Vaccine When should each vaccine be administered?
Pertussis-containing vaccine  Licensed between 16 and 32 weeks gestation (however, may be given up to eight weeks following birth)
RSV vaccine Licensed between 28 and 36 weeks gestation (* can be given off-label until discharge from maternity services)
Flu vaccine  Any time during pregnancy 

Vaccine co-administration in pregnant women 
Vaccines Can they be administered together?
Abrysvo® and anti-D immunoglobulin  ✔ 
Abrysvo® and pertussis-containing vaccine  ✔* 
Abrysvo® and seasonal influenza vaccine  ✔ 

* There is some evidence that giving the RSV vaccine with pertussis-containing vaccines may slightly reduce the immune response to pertussis. The clinical impact is unclear and likely small. To avoid this potential issue, it is recommended to administer the vaccines separately, with the pertussis vaccine given from 16 weeks and the RSV vaccine from 28 weeks. However, if a woman has not received the pertussis vaccine when she is due for the Abrysvo® RSV vaccine, both vaccines can and should be given at the same appointment to ensure timely protection for the infant. 

For pregnant women who are eligible to receive COVID-19 vaccine during a vaccination campaign, this can be given at the same time as the RSV vaccine. 

The side effects from vaccines given together are expected to be similar to the side effects of each vaccine when given alone. 

For further information about vaccine co-administration with Abrysvo®, see Respiratory syncytial virus: the green book.

Older adult RSV programme

The older adult RSV vaccination programme is a year-round programme. The recommended RSV immunisation schedule for older adults consists of a single dose given by intramuscular injection, preferably in the deltoid muscle. It should be offered to: 

  • adults turning 75 years of age 
  • all adults aged 75 years and over (as part of an extended catchup programme) 
  • all residents of care homes for older adults, regardless of age 

Invite adults who turn 75 years within 12 weeks of their birthday. 

Ensure arrangements are in place to vaccinate residents of older adult care homes as they become eligible, including outside seasonal programmes.  

Where appropriate, consider co-administering the RSV vaccine with other vaccines that the individual may be eligible for, including COVID-19, shingles and pneumococcal vaccines. 

Vaccine co-administration in older adults
Vaccines commonly administered to older adults Can they be administered together? 
Abrysvo® and Shingrix®  ✔ 
Abrysvo® and Pneumovax 23® ✔ 
Abrysvo® and COVID-19 vaccine  ✔
Abrysvo® and influenza vaccine  ✔* 

*Abrysvo® should not be routinely scheduled on the same day as the influenza vaccine in older adults. Giving Abrysvo® with the seasonal influenza vaccine may reduce the immune response to both the RSV and influenza (H3N2) components, which may increase the risk of severe respiratory disease in older adults. However, if it is thought that the individual is unlikely to return for their influenza vaccine, they can be given at the same time.   

The side effects from vaccines given together are expected to be similar to the side effects of each vaccine when given alone.  

For further information about vaccine co-administration with Abrysvo®, see Respiratory syncytial virus: the green book.

Guidance

Vaccination programme recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and Welsh Government policy can be found at the links below. 

Joint Committee on Vaccination and Immunisation – read JCVI publications and statements; search e.g., ‘Respiratory Syncytial Virus’, ‘RSV’.

Welsh Health Circulars and Welsh Government letters 

Training resources and events 

Online courses and training materials can be accessed via the E-learning page. 

Further immunisation training information and resources are provided on the Training Resources and Events page. 

Clinical resources and information

Maternal vaccination programme resources  

Older adult routine programme resources 

Patient group directions (PGDs) and protocols 

PGD templates for vaccines can be found on the Welsh Medicines Advice Service.

More information

Page last reviewed: 13th April 2026