Health

By the Retiree Report Editorial Team · Updated 2026-05-15 · 7 min read

This article is general information, not medical advice. Talk with a licensed clinician before making any decision about your care.

The RSV vaccine in 2026: who’s eligible at 60, 75, and what it costs

If you’re 75 or older, the Centers for Disease Control and Prevention now says you should get a single dose of an RSV vaccine. If you’re 50 to 74 with a chronic heart, lung, or kidney condition — or you live in a nursing home — the same recommendation applies to you. The shot is not annual, and for most people with Medicare Part D it costs $0 thanks to a 2022 law. The reason any of this matters is simple: respiratory syncytial virus sends an estimated 110,000 to 180,000 American adults age 50 and older to the hospital each year, according to the CDC.

Who the CDC says should get the vaccine

The current adult RSV recommendation was simplified in June 2024 by the CDC’s Advisory Committee on Immunization Practices. The old guidance left the decision up to “shared clinical decision-making” for everyone 60 and older, which confused both patients and providers. The new rule is cleaner. Every adult 75 and older is recommended to receive the vaccine, full stop, according to the CDC’s June 26, 2024 announcement. Adults 50 to 74 should get vaccinated if they have a condition that raises their risk of severe RSV illness.

The list of qualifying conditions is broad. The CDC’s clinical guidance page names chronic cardiovascular disease, chronic lung or respiratory disease (including COPD and asthma requiring regular treatment), end-stage kidney disease, diabetes with organ complications, chronic liver or blood disorders, neurologic conditions that affect airway clearance, moderate-to-severe immune suppression, and severe obesity with a BMI of 40 or higher. Residents of nursing homes and other long-term-care facilities are also covered, regardless of the specific diagnoses on their charts. The agency adds a catch-all line for other chronic conditions a clinician judges to raise risk, which gives doctors meaningful latitude.

If you’re under 50, the vaccine isn’t recommended for you yet outside of pregnancy. (Pfizer’s Abrysvo is approved for use in pregnant women at 32 to 36 weeks to protect newborns.) Healthy adults 50 to 59 without one of the named risk factors also fall outside the routine recommendation — the safety and efficacy data in that group is still thinner than for older adults.

How RSV vaccines differ from a flu shot

The two shots solve a similar problem — keeping a respiratory virus out of your lungs — but they work on very different schedules. A flu vaccine targets influenza strains that drift every year, so the formulation is updated each season and you need a new dose every fall. The RSV vaccine is not yet an annual shot. The CDC’s vaccine page for adults states plainly that “one dose of RSV vaccine provides protection against RSV illness in adults ages 50 years and older for at least two years,” and that people who have already been vaccinated should not receive another dose at this time, per CDC guidance for adults.

There are three FDA-licensed adult products on the U.S. market: GSK’s Arexvy, Pfizer’s Abrysvo, and Moderna’s mResvia. The CDC does not prefer one over another. Arexvy and Abrysvo are protein-based vaccines; mResvia uses messenger-RNA technology similar to the COVID-19 shots from Pfizer and Moderna. All three are given as a single intramuscular injection in the upper arm, and all three can be administered on the same day as a flu vaccine, a COVID-19 booster, or a shingles vaccine. Co-administration may produce slightly more arm soreness, but the CDC has not flagged any combined-dose safety problem.

Timing matters more than season-by-season repetition. RSV circulates mostly between October and March in the continental U.S., so the agency recommends getting the dose in late summer or early fall — August through October is the sweet spot. If you missed that window, it is still worth getting the shot later; protection begins building within about two weeks.

What it costs in 2026

For most older Americans, an RSV vaccine costs nothing out of pocket. The Inflation Reduction Act of 2022 eliminated cost-sharing for all ACIP-recommended adult vaccines covered under Medicare Part D, effective January 1, 2023. That means no copay, no coinsurance, and the vaccine does not chip away at your deductible. According to an HHS analysis, about 6.5 million Part D enrollees received an RSV vaccine free of charge in 2023, the first full year the benefit was in place. The same zero-dollar rule applies to most Medicare Advantage plans, which are required to cover Part D-equivalent vaccines at no cost when they include drug coverage.

A few cautions. The $0 price tag only holds if the shot is billed correctly under Part D, not Part B. RSV vaccines for adults are Part D drugs, while flu and COVID-19 shots are Part B. Some pharmacies and clinics get this wrong, especially when a patient gets multiple shots in one visit. If you see an unexpected charge on a receipt, ask the pharmacy to rerun the claim under your Part D plan before paying. If you ever switch plans, the Medicare Plan Finder will show whether the new plan covers RSV vaccines without cost-sharing — by federal law it must, but the formulary printout is your proof. Our walkthrough of Plan Finder covers the screen-by-screen process.

Without insurance, the retail price runs roughly $280 to $360 a dose depending on the product and pharmacy. People covered by commercial insurance generally pay nothing because the Affordable Care Act requires private plans to cover ACIP-recommended vaccines with no cost-sharing when delivered in-network. Adults under 65 without insurance or with high-deductible plans should ask about manufacturer patient-assistance programs — GSK, Pfizer, and Moderna each run one.

Safety, side effects, and the GBS warning

Most people who get an RSV vaccine experience mild, short-lived reactions: a sore arm, fatigue, headache, or muscle aches lasting a day or two. The more important conversation in the past year has been about Guillain-Barré syndrome, a rare neurologic disorder in which the immune system attacks peripheral nerves. In January 2025, the FDA required new warnings on the prescribing information for both Arexvy and Abrysvo after post-marketing studies suggested a small increased risk in the 42 days after vaccination.

The FDA’s numbers are worth reading carefully. The analyses pointed to roughly nine excess cases of GBS per million doses of Abrysvo and seven excess cases per million doses of Arexvy, in adults 65 and older. The agency stressed that the available evidence “is insufficient to establish a causal relationship,” and that the benefits of vaccination continue to outweigh the risks. The Moderna mResvia label did not receive the same warning at the time. Compare those small per-million figures against the 6,000 to 10,000 RSV-related deaths estimated among adults 65 and older every year and the math, for most older adults, still tilts toward vaccination.

That said, the decision is genuinely yours, in consultation with your clinician. If you have a personal history of Guillain-Barré syndrome — particularly after a previous vaccination — that’s a conversation to have before scheduling the shot. This article is general information, not medical advice for your situation.

What to do next

If you’re 75 or older and haven’t received an RSV vaccine, the simplest path is to call your primary-care office or your usual pharmacy and ask whether they have Arexvy, Abrysvo, or mResvia in stock. CVS, Walgreens, Costco, and most independent pharmacies administer all three. Bring your Medicare card. If you’re 50 to 74, ask your doctor whether any of your diagnoses put you in the high-risk group; most chronic heart, lung, kidney, or immune-suppression conditions do. Get the shot before October if you can, but don’t skip the year if you’re reading this in winter.

Two practical reminders. First, the RSV vaccine is one-and-done for now, so save the immunization record — your pharmacy can print one, and Medicare’s my Medicare account keeps a copy under “claims.” Second, watch for scammers. We track common impostor calls in our piece on Medicare scams to watch in 2026; a real provider will never charge a copay for an ACIP-recommended Part D vaccine, and no legitimate caller will ask for your Social Security number to “verify your free shot.”

What to remember

The CDC recommends an RSV vaccine for every adult 75 and older, and for adults 50 to 74 with chronic heart, lung, kidney, liver, blood, neurologic, or immune conditions, severe obesity, or nursing-home residence. It’s a single dose that lasts at least two seasons, not an annual shot like the flu vaccine. Medicare Part D and most commercial plans cover it at $0 thanks to the Inflation Reduction Act, so any unexpected charge should be questioned at the pharmacy counter before you pay.