Respiratory syncytial virus (RSV) vaccines: who can consider them and when?

Older people, adults who meet a product’s age and risk criteria, and pregnant women seeking to protect their infant can consider vaccination. The products and conditions differ:^[1][2]

• Older people: Hong Kong’s interim consensus dated 17 January 2025 particularly highlighted people aged 75 or above and residential-care-home residents. They may decide individually with a doctor after discussing benefits and risks.
• Other adults who meet the product criteria: the January 2026 Hong Kong Abrysvo label includes adults aged 60 or above and adults aged 18–59 at increased risk of RSV lower respiratory tract disease. Arexvy’s age and risk criteria need a separate check against its current Hong Kong label.
• Pregnant women: Abrysvo can be discussed with an antenatal doctor at 32–36 weeks to help protect the infant from birth through 6 months. Arexvy is not licensed for pregnancy.

The Hong Kong interim consensus did not recommend universal vaccination for older people or pregnant women. It supported individual decisions following medical advice and informed consent. Approved product uses and recommendations for universal vaccination serve different purposes.^[1][2][11]

Older people: the January 2025 Hong Kong consensus described a single dose. If you have already been vaccinated, give the doctor the product name and date before arranging another dose. Do not assume it is needed every year.^[1][9]

Pregnancy: the Hong Kong Abrysvo label specifies a single dose at 32–36 weeks. The Hong Kong obstetric college’s May 2025 appraisal advises discussing vaccination at 32+0–36+6 weeks when delivery is not planned within two weeks. Ask your antenatal doctor to check your pregnancy week, due date and any planned delivery date before booking.^[2][11]

Your antenatal doctor also needs to know about any risk of preterm birth. The Abrysvo trial recorded more preterm births in the vaccine group, but available data do not establish or exclude a causal link. Follow the locally approved pregnancy window rather than arranging earlier vaccination.^[2]

RSV stands for respiratory syncytial virus. It can cause serious lower respiratory tract disease, affecting the airways and lungs, particularly in infants and older people. RSV vaccines are used to prevent RSV disease; they are not a treatment for an infection that has already started.^[1][2]

The three pathways use different products and criteria. When booking, name both the product and the person who will receive it.^[2][7][8]

The vaccines have different eligible groups and uses. Your doctor checks the Hong Kong product instructions against your age and health; the clinic can confirm stock, fees and funding.^{[1][2][3][4][11]}

No. Nirsevimab (Beyfortus) and palivizumab (Synagis) are monoclonal antibodies that supply antibodies directly. Vaccines stimulate the recipient’s immune response; vaccination during pregnancy allows antibodies to pass from the mother to the infant.^[7][8]

The paediatrician will discuss prevention in light of birth timing, prematurity, heart or lung conditions, and whether the mother received an RSV vaccine. Ask which product is being offered, when it is given, and whether the baby still needs an antibody after maternal vaccination. The two approaches are not assumed to be needed together.^[7][8]

Seek medical assessment if the baby is already unwell. Preventive injections do not treat an infection that has started. See RSV symptoms in babies and when to seek care.

Side effects are possible and vary with the product and age group. Abrysvo’s Hong Kong information lists injection-site pain, headache and muscle pain among commonly reported reactions, with tiredness also reported in older adults and nausea in pregnancy. In the maternal trial, most recorded local and systemic reactions resolved within 2–3 days.^[2]

Arexvy’s EU product information describes injection-site pain, tiredness, muscle pain, headache and joint pain as common reactions; these were usually mild or moderate and resolved within a few days. This is supplementary EU safety information. Ask for the current Hong Kong leaflet for the actual product you will receive.^[5]

Rare but important risks also need discussion. Official safety information warns of a possible increased risk of Guillain–Barré syndrome after RSV vaccination in older adults. This is a neurological condition that can cause weakness. Ask the doctor what the warning means for your age group and the product being offered.^[2][6]

Tell the doctor about previous severe allergies before vaccination. Seek urgent medical help for breathing difficulty, swelling of the face or throat, or new or worsening weakness after vaccination. In pregnancy, discuss the preterm-birth warning and your pregnancy history with your antenatal doctor.^[2][5]

The local interim consensus also discusses hypertensive disorders of pregnancy in safety monitoring. Ask your antenatal doctor to explain these findings alongside your blood-pressure and pregnancy history. Events observed after vaccination are not automatically caused by the vaccine.^[1][11]

No. RSV can also cause serious disease in older people. Adults can discuss prevention with a doctor using their age, health, vaccination history and the product’s approved uses.^[1][2]

If you have questions about how long the vaccine has been studied or its safety, ask the doctor to explain the research and ongoing monitoring, including expected benefits, known risks and remaining uncertainty for your circumstances.

Ask a private clinic that offers RSV vaccination about the exact vaccine, current supply and total fee. During pregnancy, start with your antenatal doctor and confirm the pregnancy week before booking. For infant antibodies, ask the paediatrician about the child’s separate assessment.

The CHP vaccination-schemes page checked for this draft does not list RSV vaccination. For insurance, employer or other funding, check the terms of your own cover.^[10]

Price examples have their own checking dates. See RSV vaccine costs in Hong Kong and confirm the current product, recipient and total charge with the provider.

Bring any previous RSV vaccination record and list your health conditions and medicines. During pregnancy, also provide your current pregnancy week, due date and any planned delivery date.^[2][11]

• Confirm the product name and whether you will receive a vaccine or your child will receive an antibody injection.
• Ask the doctor to check age, health and previous doses. During pregnancy, the Abrysvo appointment should be within the Hong Kong-approved window of 32–36 weeks.
• Ask about common reactions, when to seek care and whom to contact.
• Confirm what the total fee includes and whether any funding applies.

Ask the clinic to record the product name and date. Keep these with your other vaccination records.