Respiratory syncytial virus (RSV) vaccine recommendations for adults: a review of available global, regional, and country level recommendations

INTRODUCTION: Respiratory syncytial virus (RSV) can cause serious disease in older adults (OAs), particularly those with underlying medical conditions. It can lead to acute respiratory illness and lower respiratory tract infections in adults ≥60 years and at increased risk groups. RSV morbidity, mortality, and health care burden are increasingly evident. This review aims to equip clinicians with practical guidance to support consistent implementation of RSV vaccination recommendations. AREAS COVERED: We examined global implementation of RSV vaccination recommendations by extracting guidelines from national immunization technical advisory groups, ministries of health, global and regional recommendations, and local medical societies. We categorized guidance by age, risk factors and comorbidities. We compared differences in indications, age thresholds, and frameworks. Across >24 countries and >50 medical societies, a common recommendation supports RSV vaccination in ≥60 years and immunocompromised individuals. The set cutoff date was November 2025. However, significant heterogeneity exists across countries in age threshold indications and risk-based eligibility, as well as in implementation depending on health system infrastructure and resources. EXPERT OPINION: Global guidance converges on prioritizing vaccination for OAs and individuals at high risk of severe disease. By synthesizing worldwide RSV vaccination recommendations, this review offers clinicians an accessible guide to support consistent RSV vaccination.