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RSV Vaccination in Adults:
Introduction
Albert Shaw, MD, PhD
Chair, Adult RSV Work Group
Advisory Committee on Immunization Practices
October 24, 2024National Center for Immunization and Respiratory Diseases
2Adult RSV Work Group Membership
ACIP Voting Members
Albert Shaw (Chair)
Helen Chu
Mini Kamboj
Keipp Talbot
Ex Officio Members
Nicholas Geagan (FDA)
Nadine Peart Akindele (FDA)
Rachel Zhang (FDA)
Michelle Juaneza (HRSA)
Uzo Chukwuma (IHS)
Sonnie Kim (NIH/NIAID)CDC Co -Leads
Amadea Britton
Michael MelgarConsultants
Robert Atmar (Baylor College of Medicine)
Doug Campos -Outcalt (University of Arizona)
Peter Donofrio (Vanderbilt University)
Marie Griffin (Vanderbilt University)
Camille Kotton (Massachusetts General Hospital)
Cynthia Lucero (Veterans Health Administration)
Rebecca Morgan (Case Western Reserve University)
Tracy Ruckwardt (NIH/NIAID)
Jonathan Temte (University of Wisconsin)Liaisons
Bindy Crouch (AIM)
April Killikelly (NACI, PHAC)
Gretchen LaSalle (AAFP)
Ruth Lynfield (NFID)
Steven Pergam (IDSA)
Kenneth Schmader (AGS)
Winnie Siu (NACI, PHAC)
Elizabeth Skoy ( APhA )
Vidya Sundareshan (ACP)
Katherine Williams (APTR)
3CDC Contributors
Melissa Coughlin
Fatima Dawood
Katherine Fleming -Dutra
Jarrett Gartin
Monica Godfrey
Aron Hall
Fiona Havers
Suzanne Heitfield
Michele Hlavsa
Jefferson Jones
Ruth Link -Gelles
Agustin Lopez
Josephine Mak
Meredith McMorrowNoelle -Angelique Molinari
Danielle Moulia
Ismael Ortega -Sanchez
Lakshmi Panagiotakopoulos
Pragna Patel
Monica Patton
Amanda Payne
Mila Prill
Lauren Roper
Melisa Shah
Diya Surie
Natalie Thornburg
Dennis Wang
Trang WisardImmunization Safety Office
Tarayn Fairlie
Julianne Gee
Anne Hause
Michael McNeil
Pedro Moro
Christine Olson
David Shay
John Su
Eric WeintraubImmunization Services Division
Erin Abramsohn
Janelle King
Andrew Leidner
Amy Parker Fiebelkorn
Jamison Pike
Influenza Division
Jill Ferdinands
Lisa GrohskopfNCIRD Office of the Director
Jessica MacNeil
Hannah Rosenblum
Melinda WhartonCoronavirus and Other Respiratory Viruses Division
4June 2024 ACIP Recommendations for RSV Vaccination
in Older Adults:
ACIP recommends all adults aged ≥75 years and adults aged 60 –74 years
who are at increased risk of severe RSV disease receive a single dose of RSV
vaccine.1,2
1. Recommendation is for any Food and Drug Administration –approved RSV vaccine ( Arexvy [GSK];
Abrysvo [Pfizer]; or mResvia [Moderna]). There is no product preference.
2. Eligible adults are currently recommended to receive a single dose of RSV vaccine; adults who have
already received RSV vaccination should not receive another dose.
https://www.cdc.gov/mmwr/volumes/73/wr/mm7332e1.htm?s_cid=mm7332e1_w
5•Protein subunit (based on RSV F protein in prefusion conformation)
-GSK Arexvy1: monovalent RSV -A, AS01E adjuvant
-Pfizer Abrysvo2: bivalent RSV -A/RSV -B, no adjuvant
•Messenger RNA (mRNA, encoding RSV F protein in prefusion conformation)
-Moderna mResvia3: monovalent RSV -A, no adjuvantCurrent FDA -approved RSV vaccines
1. https://www.fda.gov/media/167805/download
2. https://www.fda.gov/media/168889/download
3. https://www.fda.gov/media/179005/download
6•Protein subunit
-GSK Arexvy1: monovalent RSV -A, AS01E adjuvant
-Pfizer Abrysvo2: bivalent RSV -A/RSV -B, no adjuvant
•mRNA
-Moderna mResvia3: monovalent RSV -A, no adjuvantCurrent FDA -approved RSV vaccines
Approved for prevention of
lower respiratory tract
disease (LRTD) caused by RSV
in adults aged ≥60 years
1. https://www.fda.gov/media/167805/download
2. https://www.fda.gov/media/168889/download
3. https://www.fda.gov/media/179005/download
7•Protein subunit
-GSK Arexvy1: monovalent RSV -A, AS01E adjuvant
-Pfizer Abrysvo2: bivalent RSV -A/RSV -B, no adjuvant
•mRNA
-Moderna mResvia3: monovalent RSV -A, no adjuvantCurrent FDA -approved RSV vaccines
Also approved for prevention
of LRTD caused by RSV in
adults aged 50 –59 years
who are at increased risk for
LRTD caused by RSV*
*There is no current ACIP
recommendation for RSV vaccination in
non-pregnant adults aged <60 years.1. https://www.fda.gov/media/167805/download
2. https://www.fda.gov/media/168889/download
3. https://www.fda.gov/media/179005/download
8•Protein subunit
-GSK Arexvy1: monovalent RSV -A, AS01E adjuvant
-Pfizer Abrysvo2: bivalent RSV -A/RSV -B, no adjuvant
•mRNA
-Moderna mResvia3: monovalent RSV -A, no adjuvantCurrent FDA -approved RSV vaccines
Also approved and
recommended for active
immunization of pregnant
individuals of any age* at
32–36 weeks gestational age
for the prevention of LRTD
and severe LRTD caused by
RSV in infants from birth
through 6 months of age.
1. https://www.fda.gov/media/167805/download
2. https://www.fda.gov/media/168889/download
3. https://www.fda.gov/media/179005/download*There is no current ACIP
recommendation for RSV vaccination in
non-pregnant adults aged <60 years.
9•Protein subunit
-GSK Arexvy1: monovalent RSV -A, AS01E adjuvant
-Pfizer Abrysvo2: bivalent RSV -A/RSV -B, no adjuvant
•mRNA
-Moderna mResvia3: monovalent RSV -A, no adjuvantCurrent FDA -approved RSV vaccines
As of 10/22/244: also
approved for prevention of
LRTD caused by RSV in adults
aged 18 –59 years who are at
increased risk for LRTD
caused by RSV*
1. https://www.fda.gov/media/167805/download
2. https://www.fda.gov/media/168889/download
3. https://www.fda.gov/media/179005/download
4. https://www.pfizer.com/news/press -release/press -release -detail/us -fda-approves -pfizers -rsv-vaccine -abrysvor -adults -aged -18*There is no current ACIP
recommendation for RSV vaccination in
non-pregnant adults aged <60 years.
10•No vote at today’s meeting
•Since June, the Work Group has been reviewing updated data relevant
to current recommendations and discussing potential policy options for
an RSV vaccination recommendation in adults aged <60 years
•Today, ACIP will see presentations from FDA, as well as manufacturer
presentations with updates on co -administration, duration of protection,
and immunogenicity in adults with immune compromise
•The Work Group will share interpretations regarding these updates and
considerations for future policy Today’s meeting
11Agenda: Thursday October 24, 2024
•Manufacturer presentation: mResvia (Moderna) coadministration
with high -dose influenza vaccine
•Manufacturer presentation: Abrysvo (Pfizer) immunogenicity in
immunocompromised adults and coadministration with COVID -19
and influenza vaccines
•Manufacturer presentation: Arexvy (GSK) season 3 update on
safety, efficacy and immunogenicity in solid organ transplant
recipients
•Evaluation of Guillain -Barré Syndrome (GBS) following protein
subunit RSV vaccination among adults 65 years and older
•Work Group interpretations
•ACIP open discussion and questions •Dr. Rituparna Das (Moderna)
•Dr. Iona Munjal (Pfizer)
•Dr. Susan Gerber (GSK)
•Dr. Patricia Lloyd (FDA)
•Dr. Michael Melgar (CDC)
For more information, contact CDC
1-800-CDC-INFO (232 -4636)
TTY: 1 -888-232-6348 www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position
of the Centers for Disease Control and Prevention.