Summary of the National Advisory Committee on Immunization (NACI) Statement: Updated guidance on respiratory syncytial virus (RSV) vaccines for older adults and for adults at high risk of severe RSV disease.

BACKGROUND

Respiratory syncytial virus (RSV) is a common respiratory virus that can have serious complications for older adults and adults with certain medical conditions. Since July 2024, the National Advisory Committee on Immunization (NACI) has provided immunization guidance for the protection of older adults against RSV. In April 2026, NACI updated its guidance to reflect emerging epidemiological data identifying younger adults at high risk of severe RSV and evidence on the benefits of RSV vaccines in older adults and adults at high risk.

METHODS

NACI reviewed available evidence on the benefits and risks of RSV vaccination in older adults and individuals at higher risk, as well as additional factors, including ethics, equity, feasibility, acceptability and cost-effectiveness.

RESULTS

The RSV disease burden in younger adults with certain underlying conditions is comparable to that in older adults. Among older adults, RSV infection may increase the risk of cardiovascular events and Guillain-Barré syndrome (GBS). The RSV vaccines demonstrate strong protection against RSV-associated lower respiratory tract disease and severe outcomes, with favourable safety profiles. Monitoring for rare adverse events following immunization, total duration of protection, and need for boosters is ongoing.

CONCLUSION

NACI expanded the use of RSV vaccines to some adults at high risk for whom the balance of clinical benefits, safety and feasibility is favourable. NACI strongly recommends RSV immunization programs for all adults aged 75 years and older; adults aged 65-74 who are at increased risk of severe RSV disease; and adults aged 18 years and older who reside in chronic care facilities, have received a lung or hematopoietic stem cell transplant, are receiving home or chronic oxygen therapy, or are receiving dialysis. For other adults, vaccination may be considered on an individual basis.