RSV Shots After 65: How Often Do You Really Need the Vaccine?
RSV Vaccination After 65: How Often Should You Get the Shot?
If you’re over 65 and got an RSV (respiratory syncytial virus) vaccine a couple of years ago, you’re not alone in wondering: “Do I need another one—and if so, how often?” The news, recommendations, and even friends’ experiences can sound confusing, especially if you already keep up with flu and COVID-19 boosters.
In this guide, we’ll walk through what doctors and researchers currently know about RSV in older adults, how long the vaccines seem to protect you, and what leading health organizations recommend about repeat doses. You’ll also get practical questions to take to your own clinician so you can make a decision that fits your health, not just your age.
What Is RSV and Why Does It Matter After Age 65?
RSV, or respiratory syncytial virus, is a common virus that infects the nose, throat, and lungs. Many people first hear about it in connection with infants, but RSV is also an important cause of serious respiratory disease in adults—especially older adults.
In healthy younger adults, RSV often looks like a bad cold. In people over 65, it can:
- Trigger pneumonia
- Worsen chronic lung disease (like COPD or asthma)
- Exacerbate heart failure or coronary artery disease
- Cause hospitalization and, in some cases, death
“For adults 65 and older, RSV is now recognized as a major cause of hospitalization—on the same order of magnitude as influenza in many seasons.”
— Infectious disease specialist, summarizing recent RSV data in older adults
This is why public health agencies began recommending RSV vaccination for older adults in recent years: to prevent the most severe outcomes, not necessarily every mild infection.
RSV Vaccines for Older Adults: What’s Available?
As of late 2025, several RSV vaccines are licensed for adults 60 and older in the United States and other countries. Brand names change by region, but in general, these are:
- Protein-based RSV vaccines (e.g., GSK’s Arexvy, Pfizer’s Abrysvo)
These contain a stabilized RSV F protein that trains your immune system to recognize and fight the virus. - Newer or updated formulations (in some regions)
Some countries are evaluating updated doses or formulations for specific high-risk groups.
These vaccines were first rolled out widely around 2023. Many adults 65 and older, like the couple in the OregonLive question, received their first RSV shot in the 2023–24 season, meaning they are now 1–2+ years out from their initial dose.
How Long Does RSV Vaccine Protection Last?
Early clinical trials followed participants for two RSV seasons. Those studies suggested that protection against severe RSV disease—hospitalization, very low oxygen levels, or intensive care—remained meaningful for at least two seasons, though it did decline over time.
- First RSV season after vaccination: Highest protection, especially against hospitalization and severe lower respiratory infection.
- Second season: Some waning of protection, but still a reduced risk of severe disease compared with unvaccinated adults.
- Beyond two seasons: Ongoing studies are still clarifying how much protection remains after year two.
Current evidence suggests that, unlike flu shots, RSV vaccines do not necessarily need to be given every year for everyone. But older age and certain medical conditions may justify repeat dosing.
How Often Should Adults Over 65 Get the RSV Vaccine?
The specific question—“We’re over 65 and had an RSV shot two years ago. Do we need another one now?”—does not yet have a single universal answer for everyone. Recommendations may differ slightly by country and may evolve, but the pattern looks like this:
1. General guidance (e.g., U.S. CDC–style approach)
In many regions, health agencies currently recommend:
- At least one lifetime RSV vaccine dose for adults 60 and older, using shared clinical decision-making.
- No automatic annual booster for everyone over 65—unlike the yearly flu shot.
- Possible repeat doses considered for:
- Adults 75+ years
- Adults 60–74 with high-risk conditions (serious heart, lung, immune, or kidney disease)
- Residents of long-term care facilities
2. Two years out from your first RSV vaccine
If you and your spouse are over 65 and received the RSV vaccine two years ago, many clinicians will consider:
- Your age now (for example, 66 vs. 82).
- Your medical conditions (heart failure, COPD, asthma, diabetes, cancer treatment, etc.).
- Recent respiratory infections or hospitalizations.
- How well you tolerated the first RSV vaccine.
- Local RSV activity and updated public health advice for the upcoming season.
For a generally healthy 66-year-old, a second dose may be optional or not yet routinely recommended. For an 82-year-old with COPD who was hospitalized with pneumonia last winter, many doctors would lean more strongly toward offering another RSV dose when the season approaches—if local guidelines support it.
A Real-World Example: Two Different 70-Year-Olds
To make this more concrete, here are two fictional but realistic scenarios based on what clinicians commonly see.
Scenario A: “Mostly healthy, active 70-year-old”
- Age: 70
- Conditions: Mild high blood pressure, well controlled
- Got first RSV shot: Two years ago, mild sore arm only
- No hospitalizations, walks daily, lives independently
In this case, many doctors might say: “You’ve had two seasons of good protection. The data on boosters beyond this point are still emerging. We can consider another dose if updated guidelines support it, but there isn’t yet a strong requirement to repeat it every year for someone with your risk profile.”
Scenario B: “78-year-old with COPD and heart failure”
- Age: 78
- Conditions: COPD, heart failure, type 2 diabetes
- Got first RSV shot: Two years ago
- Had RSV pneumonia last winter requiring a 5-day hospitalization
For this person, many clinicians would have a stronger discussion about a repeat RSV shot before the next RSV season, because:
- They are older than 75.
- They have multiple high-risk conditions.
- They already experienced severe respiratory illness.
Case discussions like these are how “shared decision-making” works: your age, health, and values drive the conversation, not a one-size-fits-all calendar schedule.
When Is the Best Time to Get (or Repeat) an RSV Shot?
RSV season typically overlaps with flu and COVID-19 surges: fall through early spring in many parts of North America and Europe. To maximize protection during peak virus activity, most guidance favors vaccinating in the months before RSV begins circulating widely.
For many adults, that means:
- Late summer to early fall (for example, August–October in the Northern Hemisphere)
- Earlier or later depending on local RSV trends in your region
RSV vaccination can often be given at the same visit as flu or COVID-19 shots, though some people prefer to separate them by a week or two to better track side effects.
Risks, Side Effects, and Safety Considerations
RSV vaccines for older adults went through large clinical trials before approval and have been used in millions of people. Most side effects are mild and temporary:
- Sore arm, redness, or swelling where the shot was given
- Fatigue or low energy for a day or two
- Headache or muscle aches
- Occasional low-grade fever
Serious adverse events are uncommon but can include allergic reactions and, rarely, neurologic or inflammatory conditions. Safety monitoring systems continue to track these events.
Before and After RSV Vaccination: What Changes?
RSV vaccination doesn’t create a “force field” against every sniffle, but for many high-risk adults, it can change the likelihood of landing in the hospital. Think of it as adding another layer of protection on top of flu shots, COVID-19 boosters, and healthy habits.
Again, the goal is not perfection—it’s reducing the odds of severe outcomes. That’s why the decision about repeat doses after two years focuses on those most likely to benefit from an extra layer of protection.
How to Talk With Your Doctor About Another RSV Shot
If you’re over 65 and had an RSV vaccine two years ago, the next best step is a focused, practical conversation with your health care provider. To make that talk easier, you might bring a simple checklist.
Questions you can ask
- “Based on my age and health problems, what is my personal risk from RSV?”
- “I received an RSV shot in [year]. Do you think I should get another this coming season?”
- “What does the latest guidance in our region say about repeat RSV doses after two years?”
- “Can I safely get RSV, flu, and COVID-19 shots around the same time?”
- “What side effects should I watch for based on my medications and conditions?”
Information to share with your clinician
- Any hospital stays or ER visits for breathing problems in the last 2–3 years
- New diagnoses (heart failure, COPD, cancer, kidney disease, autoimmune disease)
- Current medications, especially drugs that weaken your immune system
- How you reacted to your first RSV shot (and other vaccines)
The Science Is Still Evolving—Here’s How to Stay Up to Date
RSV vaccines for older adults are relatively new compared with long-established vaccines like tetanus or measles. That means health agencies are still refining how often they should be given. Large ongoing studies are tracking:
- How quickly protection wanes beyond the second RSV season
- Which medical conditions benefit most from repeat dosing
- Safety and side effect patterns with repeated doses
- Whether updated formulations provide longer or broader protection
Reputable places to check for updated information include:
- National public health agency websites (such as the CDC, Public Health England, Health Canada)
- Large academic medical centers and university hospital websites
- Professional societies in infectious diseases, geriatrics, and pulmonology
As new data appear, recommendations may shift. Rather than memorizing a fixed schedule, aim to revisit the RSV vaccine question with your clinician every year or two—just like you do for flu and COVID-19 boosters.
Putting It All Together: What Should You Do Now?
If you and your spouse are over 65 and got your RSV vaccines two years ago, you’ve already taken an important step to lower your risk of serious illness. The main decision now is whether your age and health conditions justify a repeat dose before an upcoming RSV season.
For many generally healthy adults in their mid-60s or early 70s, a single dose may still be providing meaningful protection into the second or even third season, with no automatic need for annual repeat shots. For older adults—especially 75+—or those with significant heart, lung, immune, or kidney problems, a second dose after two years may be reasonable, depending on up-to-date local guidance.
A simple three-step plan
- Write down when you received your RSV vaccine and any major health changes since then.
- Schedule a fall check-in with your clinician to review RSV, flu, and COVID-19 vaccination plans together.
- Decide as a team whether a repeat RSV shot this season makes sense for each of you individually.
You don’t need to navigate the science alone. By asking informed questions and partnering with your health care team, you can make a calm, confident decision about RSV vaccination that respects both the best available evidence and your real life.
