RSV Symptoms in Adults: How to Tell It From Flu and COVID, and Who Is at Risk

The pharmacist’s line this week ran past the vitamin aisle, and most people in it were not there for themselves. They were asking about a parent, a partner on chemotherapy, a spouse with COPD who “just has a cold.” Searches for rsv symptoms adults have climbed with the first cool mornings, and the reason is not only the calendar. As of September 2026, three licensed RSV vaccines are available for adults in the United States, eligibility now reaches down to age 50 for people with certain health conditions, and surveillance data from the first full seasons of use have given clinicians something they never had before: real-world numbers.

That is new. For decades, respiratory syncytial virus (RSV), a common virus that infects the nose, throat and lungs, was filed under childhood illnesses. Adults caught it, shrugged it off, and rarely learned its name. The shift in attention has also stirred up confusion, with social feeds offering symptom checklists that promise to sort RSV from flu and COVID at a glance.

They cannot. Here is what the evidence actually supports, and what matters most for the people most likely to be harmed.

What does RSV feel like in a healthy adult?

For most adults with a healthy immune system, RSV is a nuisance rather than an emergency. The Mayo Clinic and CDC describe a cluster of upper-respiratory complaints: a congested or runny nose, sneezing, a dry cough that may turn productive, a scratchy sore throat, a low-grade fever and a general sense of being worn down. Headache and reduced appetite are common. Some adults notice wheezing, a whistling sound when breathing out, which is the virus irritating the smaller airways.

Two features stand out when you compare it with other winter infections. The onset is gradual. People often describe a day or two of feeling slightly off before the cough settles in, which contrasts with the “hit by a truck” start that flu is known for. The second is the cough itself, which can outlast everything else by a week or more. That lingering cough is why adults sometimes assume they have developed bronchitis or a secondary infection when the original virus is simply slow to leave.

Fever, when present, tends to be modest. Temperatures above 102°F (38.9°C) in an otherwise healthy adult are less typical of RSV and should prompt a wider look. Loss of taste or smell is not a recognized RSV feature.

One important caveat: a mild case in you can be a severe case in someone else. Adults with light symptoms still shed virus, and household studies consistently show that RSV in older adults is often traced back to a grandchild or an adult with what felt like an ordinary cold. The symptoms you can tolerate are not a measure of the risk you carry into someone else’s home.

RSV symptoms in adults: the typical timeline, day by day

RSV follows a fairly predictable arc, and knowing it helps you judge whether an illness is behaving as expected or veering off course.

Exposure comes first, usually through droplets from a cough or sneeze or from touching a contaminated surface and then your face. The incubation period, the gap between catching a virus and feeling ill, runs about 4 to 6 days according to CDC, with a range of 2 to 8 days.

Days 1 to 3 of illness bring the upper-airway symptoms: congestion, sneezing, sore throat, perhaps a mild headache. Many adults feel well enough to work, which is precisely when transmission is most efficient.

Days 3 to 5 are the peak. Cough deepens, fever is most likely now, and fatigue sets in. This is the window in which adults with lung or heart disease are most likely to notice shortness of breath or wheezing, and it is the stretch to watch closely in anyone at higher risk.

Days 5 to 10 should show steady improvement. Fever resolves, energy returns, congestion thins out. The cough may persist beyond two weeks in a minority of people without signaling complications, though a cough that worsens rather than fades after day 7 deserves attention.

• Symptoms that improve, then sharply worsen, suggest a secondary bacterial infection such as pneumonia.
• New breathlessness at rest, at any point, is not part of a normal RSV course.
• Confusion or unusual drowsiness in an older adult can be the only sign of serious illness.

Most adults are back to baseline within 1 to 2 weeks. If the curve is heading the other way, the virus has stopped being the only problem.

RSV vs flu vs COVID: how to tell them apart

Honest answer first: you usually cannot, not with confidence, and clinicians cannot either without a test. The three viruses share a respiratory address and a winter schedule. What the evidence offers are tendencies, patterns seen across thousands of patients that shift the odds without closing the case.

Feature	RSV	Influenza	COVID-19
Onset	Gradual, over 1–3 days	Abrupt, often within hours	Variable
Fever	Low-grade or absent	High, 101–104°F common	Variable, may be absent
Body aches	Mild	Prominent, often severe	Common, moderate
Wheezing	Relatively common	Less common	Less common
Runny nose, sneezing	Prominent	Less prominent	Variable
Loss of taste or smell	Not typical	Not typical	Possible, less frequent with newer variants
Typical duration	1–2 weeks	About 1 week, fatigue longer	1–2 weeks, longer in some

Flu’s calling card is speed and ache: people often remember the hour they got sick. RSV creeps. COVID remains the least predictable of the three, which is one reason the loss of smell that defined early waves is no longer a reliable sorting tool.

These tendencies come largely from observational data, meaning comparisons of patients who tested positive for each virus rather than controlled experiments. They describe populations well and individuals poorly. A 72-year-old with heart failure may have RSV with a high fever, or flu with barely any. The table is a guide to probability, not a diagnosis.

Why symptoms alone cannot settle it, and what a test adds

If the three infections feel alike, why does telling them apart matter? Because the next steps differ. Influenza has antiviral medicines that work best when started within the first two days of illness. COVID-19 has its own treatment options for people at higher risk. RSV currently has no antiviral treatment approved for routine use in adults, so care is supportive. An untested “bad cold” in a vulnerable adult can mean a missed window for the one virus that does have a time-sensitive treatment.

Testing has become far simpler than it was. Many clinics and urgent-care settings use a multiplex PCR swab, a single nose or throat sample that checks for influenza A and B, SARS-CoV-2 and RSV at once. Results often return the same day. Rapid antigen tests for RSV exist but are less sensitive in adults than in infants, because adults shed less virus; a negative rapid test in an adult does not rule RSV out. The Cleveland Clinic notes that PCR is preferred for adults for exactly that reason.

Who should be tested? Guidance is pragmatic rather than universal. Testing is most valuable when the result would change management: in adults who are older, immunocompromised, or living with chronic heart or lung disease, in anyone sick enough to be considered for hospital care, and in people who live or work with those groups. A healthy 35-year-old with a sniffle rarely needs a swab, though knowing the answer still helps them protect an elderly parent.

Testing also feeds surveillance. The real-world vaccine effectiveness figures now shaping recommendations exist because hospitals tested systematically. Every swab contributes a data point to a picture that, five years ago, barely existed for adults.

RSV in elderly adults: why the illness looks different after 65

The textbook list of RSV symptoms was written largely from younger patients. In older adults, the picture shifts in ways that can delay recognition.

Fever is frequently blunted or absent. The aging immune system mounts a weaker inflammatory response, so a dangerous infection may run with a normal thermometer reading. In its place, families notice vaguer signs: a parent who is sleeping more, eating less, seems muddled, or has had a fall. Johns Hopkins and Mayo Clinic both flag confusion and functional decline as presenting features of respiratory infection in the elderly, and RSV is no exception.

The lower airways are more often involved. Where a 40-year-old gets a stuffy nose, a 78-year-old is more likely to develop bronchiolitis (inflammation of the small airways) or pneumonia, with breathlessness and a drop in oxygen levels that may not be obvious without a pulse oximeter. CDC estimates that RSV causes roughly 100,000 to 150,000 hospitalizations and 4,000 to 10,000 deaths each year among US adults aged 65 and older. Those figures place RSV in the same league as influenza for this age group, something that surprised many clinicians when robust surveillance began.

Existing conditions get worse. RSV is a recognized trigger for exacerbations of COPD and asthma, and it can tip stable heart failure into decompensation, with fluid building up in the lungs and legs. Cardiac events, including heart attacks, cluster in the weeks after respiratory infections. In the hospital data, a substantial share of older adults admitted with RSV are there because a chronic condition flared, not because of the viral pneumonia itself.

Recovery is slower too. Older adults hospitalized with RSV spend comparable or longer time in hospital than those admitted with flu in several observational cohorts, and a meaningful fraction do not return to their previous level of independence.

Who is at risk from RSV as an adult?

Age is the strongest single predictor of severe RSV, but it is far from the only one. CDC and NHS guidance converge on a list of conditions that raise the odds of a hospital stay, and they are worth knowing whether the person in question is you or someone you care for.

• Chronic lung disease: COPD, moderate to severe asthma, bronchiectasis, interstitial lung disease, cystic fibrosis.
• Chronic heart disease: heart failure, coronary artery disease, and some congenital conditions.
• Weakened immunity: from cancer treatment, organ or stem-cell transplant, advanced HIV, or long-term use of immune-suppressing medicines.
• Diabetes, particularly when it has caused complications or is poorly controlled.
• Chronic kidney or liver disease.
• Severe obesity, defined clinically as a body mass index of 40 or above.
• Neurological or neuromuscular conditions that weaken the cough or impair swallowing.
• Living in a nursing home or long-term care facility, where exposure is high and frailty is common.

Why these? The common thread is reserve. A healthy lung can lose some function to viral inflammation and still deliver enough oxygen; a lung already scarred by COPD cannot. A strong immune system clears the virus in days; a suppressed one may let it replicate for weeks, which is why transplant recipients can develop prolonged, severe lower-respiratory disease from a virus that barely registers in their visitors.

Pregnancy deserves a separate note. Adults who are pregnant are not at markedly higher risk themselves, but RSV is the leading cause of infant hospitalization in the first year of life, and a maternal vaccine given late in pregnancy passes protective antibodies to the baby. That is why pregnancy appears in vaccine eligibility lists even though it is not a risk factor for the parent.

How long does RSV last in adults, and is RSV contagious the whole time?

Two questions arrive together in almost every conversation about RSV, and they have different answers.

Duration first. In healthy adults, the illness runs 1 to 2 weeks. Congestion and fever typically clear within a week; cough is the straggler and may hang on for two to three weeks in some people. NHS guidance frames a normal course as improvement within about a week to two weeks, and that is a reasonable yardstick. Older adults and those with chronic conditions should expect a longer tail, and anyone immunocompromised may feel the effects for considerably longer.

Contagiousness is a narrower window than most people assume. CDC states that people with RSV are usually contagious for 3 to 8 days, and may be infectious a day or two before symptoms appear. That pre-symptomatic day is the one that matters for households: the adult who feels fine on Tuesday and ill on Wednesday was already spreading virus at Tuesday’s dinner.

Infants and people with weakened immune systems are the exception. They can shed virus for as long as four weeks, even after symptoms fade, which is why hospital infection-control teams treat immunocompromised RSV patients with extended precautions.

The virus is durable outside the body. On hard surfaces such as countertops and door handles, it can remain infectious for several hours; on hands and soft surfaces, for shorter periods. That durability, combined with its spread through large droplets rather than fine aerosols, means close contact and shared objects drive most transmission. Handwashing is unglamorous and effective.

Immunity after infection is partial and short-lived. Adults can and do catch RSV repeatedly across a lifetime, usually with milder illness each time in healthy people, though severity depends more on current health than on prior exposure.

What changed recently in RSV guidance for adults

The last two years rewrote the adult RSV landscape, and several dated changes explain why the topic is back in the news.

June 2024. CDC moved from a “shared clinical decision-making” model to a clear recommendation: a single dose of RSV vaccine for all adults aged 75 and older, and for adults aged 60 to 74 at increased risk of severe disease. The change followed a first season of data suggesting benefit was concentrated in those groups.

September 2024. The NHS launched a national RSV vaccination program in the UK, offering a single dose to adults aged 75 to 79 and to pregnant women from 28 weeks of pregnancy.

January 2025. The US Food and Drug Administration required the two protein-based RSV vaccines, Arexvy and Abrysvo, to carry a warning about Guillain-Barré syndrome, a rare condition in which the immune system attacks peripheral nerves, after post-marketing surveillance identified a small increased risk in older adults.

June 2025. CDC adopted an expanded recommendation covering adults aged 50 to 59 who have conditions that raise their risk, aligning with FDA approvals that had extended the licensed age range downward. The same month, the mRNA vaccine mRESVIA received approval for at-risk adults aged 18 to 59.

Through the 2025–26 season. CDC continued to recommend one dose only, with no booster, while follow-up studies tracked how long protection lasts. Observational data showed protection persisting into a second season, though at a reduced level.

The practical upshot for autumn 2026: more adults are eligible than ever, the recommendation is clearer than it was, and the safety profile is better characterized. Whether any individual should be vaccinated remains a conversation with their own clinician, who knows their history.

What the evidence actually says, and how strong it is

Grading the evidence matters because not every claim about RSV rests on the same footing. Here is where the strongest and weakest data sit.

Vaccine efficacy in older adults: strong, randomized-trial evidence. Each of the three vaccines was tested in a large placebo-controlled trial enrolling tens of thousands of adults aged 60 and over. Efficacy against RSV lower-respiratory-tract disease in the first season was roughly 83% for Arexvy, about 67% to 86% for Abrysvo depending on symptom threshold, and about 84% for mRESVIA. These are the highest-quality numbers in the field. Their limitation is that trials enrolled relatively healthy volunteers and were not powered to measure protection against hospitalization or death directly.

Real-world effectiveness: moderate-strength observational data. CDC network studies from the 2023–24 and 2024–25 seasons estimated effectiveness against RSV hospitalization in adults 60 and older in the range of 75% to 80%, including in people with chronic conditions and immunocompromise who were underrepresented in trials. Observational designs can be confounded, but the consistency across networks strengthens confidence.

Duration of protection: emerging data. Trial extensions and surveillance suggest meaningful protection into a second season, declining thereafter. Whether and when a repeat dose is warranted is still an open question, which is why none is currently recommended.

Safety signals: surveillance data. The Guillain-Barré association comes from passive and active monitoring systems rather than trials, which were too small to detect such a rare event. Current estimates put the excess risk at a few cases per million doses, a figure clinicians weigh against the risk of RSV itself.

Symptom-based differentiation from flu and COVID: weak. This rests on descriptive comparisons, not validated clinical prediction tools. It informs suspicion and nothing more.

How RSV is treated in adults when there is no antiviral

The absence of a specific antiviral for adult RSV frustrates patients who expect a prescription to match the diagnosis. What exists instead is supportive care, and for the majority of adults it is enough.

At home, that means rest, fluids, and relief of symptoms. Over-the-counter fever and pain reducers can ease aches and lower temperature; which product suits you depends on your other medicines and conditions, so a pharmacist or clinician is the right person to ask. Humidified air and saline nasal rinses can loosen congestion. Honey in warm drinks has modest trial evidence for cough in adults and is a reasonable low-risk option. Decongestant choices matter for people with high blood pressure or heart disease, another reason to check before reaching for a familiar box.

Antibiotics do nothing against RSV. Clinicians prescribe them only if a bacterial complication such as pneumonia or sinusitis develops, and overuse carries real harms. A request for “something stronger” for a viral cough is a request that cannot be filled.

Adults with asthma or COPD often need their usual inhaled treatments stepped up during an RSV infection, and some will need a short course of oral steroids. That adjustment belongs to the prescribing clinician; the right move is to call early, ideally when symptoms first appear, rather than waiting for a crisis. Many respiratory clinics provide written action plans for exactly this scenario.

In hospital, treatment centers on oxygen, fluids, and support for the heart and lungs. Severely immunocompromised patients are occasionally treated with the antiviral ribavirin, which carries significant toxicity and is used only in specialist settings. Several oral antivirals for RSV are in clinical trials; none is approved for adult use, and none is available outside research.

RSV vaccines for adults: who is currently eligible

Eligibility differs slightly between countries, so the cleanest approach is to state each major body’s current position.

United States (CDC). A single dose of RSV vaccine is recommended for all adults aged 75 and older; for adults aged 60 to 74 at increased risk of severe RSV; and for adults aged 50 to 59 at increased risk. “Increased risk” follows the conditions listed earlier: chronic heart or lung disease, weakened immunity, diabetes with complications, advanced kidney or liver disease, severe obesity, certain neurological conditions, and residence in a nursing home. Three products are licensed: Arexvy, Abrysvo and mRESVIA. For adults aged 18 to 49 with risk conditions, licensure exists for some products but CDC has not issued a routine recommendation. A separate recommendation covers pregnancy: Abrysvo during weeks 32 through 36 of pregnancy, in season, to protect the infant.

United Kingdom (NHS). The RSV vaccine is offered to adults aged 75 to 79 and to pregnant women from 28 weeks. People who were already 80 when the program launched were offered a time-limited catch-up.

World Health Organization. WHO’s formal recommendations to date have prioritized infant protection through maternal vaccination and long-acting antibodies, and it advises national programs to weigh older-adult vaccination against local disease burden and resources.

Timing is late summer or early autumn, before RSV begins circulating, though vaccination later in the season still offers benefit. The RSV vaccine can be given at the same visit as flu and COVID vaccines.

None of this substitutes for an individual decision. A clinician will consider your age, conditions, previous vaccine reactions and personal history before recommending for or against. If you are unsure whether you fall into an eligible group, that is the first question to bring to your next appointment.

Common myths about RSV in adults, corrected

Viral posts about RSV tend to recycle the same handful of claims. Each has a factual correction.

“RSV is a kids’ virus; adults don’t really get it.” Adults get RSV throughout life. Most infections are mild and go unnamed, which is exactly why the myth persists. In adults over 65, RSV causes a hospitalization burden comparable to influenza.

“If you don’t have a fever, it isn’t serious.” Older adults often have no fever even with pneumonia. Breathlessness, confusion and reduced intake are more reliable warning signs after 65 than the thermometer.

“You can tell RSV from flu by checking whether you have a runny nose.” Runny nose is more common in RSV, but plenty of flu patients have one and plenty of RSV patients do not. Only a test distinguishes them.

“The RSV vaccine gives you RSV.” None of the adult RSV vaccines contains live virus. Two use a stabilized viral protein and one uses mRNA instructions for that protein; none can cause infection. Common side effects are a sore arm, fatigue and headache for a day or two.

“Once you’ve had RSV, you’re immune.” Natural immunity is partial and fades within months to a couple of years. Repeat infections across adulthood are the norm.

“Antibiotics will clear it up faster.” Antibiotics have no effect on viruses. They are reserved for confirmed or strongly suspected bacterial complications.

“Healthy people don’t need to worry about spreading it.” A healthy adult’s mild case is the most common source of RSV in a hospitalized grandparent. The risk you pose to others is unrelated to how sick you feel.

Protecting a vulnerable adult at home when someone has RSV

Most severe adult RSV begins with an ordinary exposure at home. The measures that reduce it are familiar from other respiratory viruses, applied with a bit more discipline for the first week.

Start with distance where you can. If a grandchild or household member has cold symptoms, postpone visits to anyone over 75 or anyone immunocompromised until symptoms have resolved, ideally a full week from onset. When separation is not possible, keep the sick person’s close contact with the vulnerable adult brief and, where tolerated, masked.

Hands next. RSV spreads efficiently via surfaces and hands, so soap-and-water washing for 20 seconds, or alcohol-based sanitizer when a sink is not handy, interrupts the main route. Target the moments that matter: after coughing or sneezing, before preparing food, before touching the face. Wipe shared high-touch surfaces such as door handles, remote controls, phones and tap handles daily with a household disinfectant during the illness.

Do not share cups, utensils or towels. Cough and sneeze into a tissue or elbow, and dispose of tissues immediately rather than leaving them on surfaces where virus survives for hours.

Ventilation helps. Opening windows for a few minutes several times a day dilutes airborne droplets, and it costs nothing.

For the vulnerable adult, two steps matter most: being vaccinated if eligible, well before the season, and having a low threshold to call a clinician if any respiratory symptoms begin. Pulse oximeters, small fingertip devices that estimate blood oxygen, are reasonable for households with someone who has chronic lung or heart disease; a reading that is dropping or sits below the person’s usual baseline is a reason to seek care, even if they do not look especially unwell.

When to see a doctor about RSV symptoms in adults

Most adults can manage RSV at home. The decision to seek care turns on who is sick and how the illness is behaving, and some signs should never wait.

Seek urgent or emergency care, same day, for any of the following:

• Shortness of breath at rest, or breathing that is fast, labored or noisy.
• Blue or gray tinge to lips, face or nail beds.
• Chest pain or pressure, or a racing or irregular heartbeat.
• New confusion, difficulty staying awake, or a fall in an older adult.
• Inability to keep fluids down, very little urine, or signs of dehydration such as dizziness on standing.
• Blood oxygen reading below 92%, or several points below the person’s known baseline.
• Fever above 103°F (39.4°C) that does not respond to usual measures, or any fever in someone who is immunocompromised.

Call your regular clinician within a day or two if:

• You are over 60, pregnant, or have heart, lung, kidney or immune conditions and have developed cold-like symptoms, especially cough. Early testing may open the door to flu or COVID treatment if that is what you actually have.
• Symptoms improved and then worsened again, which can signal a bacterial complication.
• Cough is still worsening after seven days, or persists beyond three weeks.
• Wheezing is new, or your usual asthma or COPD inhalers are not controlling symptoms as they normally do.

If you take prescribed medicines for a heart or lung condition, do not stop or adjust them on your own during an infection. Changes to inhalers, steroids, diuretics or any other treatment belong to the clinician who prescribes them, who can also decide whether testing or a chest examination is warranted. When in doubt, a phone call costs little and clarifies much.

The one thing worth remembering about RSV after 50

Strip away the symptom checklists and the comparison charts and a single idea remains: RSV in adults is a disease of reserve. The virus is roughly the same in a healthy 30-year-old and a frail 80-year-old. What differs is how much lung function, heart function and immune capacity each person can spare while the infection runs its course. That is why the same pathogen produces a week of sniffles in one household member and a hospital admission in another.

It follows that the most useful question is not “Is this RSV?” but “Who in this house cannot afford it?” If the answer is nobody, supportive care and courtesy to others are enough. If the answer is someone, the plan changes: earlier testing, a lower bar to call a clinician, and a serious look at vaccination for the person at risk before the season begins.

The evidence for that last step is unusually good by the standards of adult vaccines. Three large randomized trials, now backed by two seasons of real-world effectiveness data, show roughly a three-quarters reduction in RSV hospitalization among older adults. The known risks are small and well characterized. Whether that balance favors vaccination for any given individual is a decision for them and their clinician, informed by their own history, and it is a decision best made in September rather than in January.

For everyone else, the responsibility is quieter. Wash your hands, keep your cold away from your grandmother, and stop trusting a runny nose to tell you which virus you have. The swab knows. You do not. That humility, more than any symptom list, is what protects the people RSV actually harms.

Frequently asked questions

What are the first signs of RSV in adults?

The earliest signs are usually a congested or runny nose, sneezing and a scratchy throat, followed within a day or two by cough and fatigue. Fever, if it comes, is typically mild. These early symptoms are indistinguishable from a common cold, which is why most adults never learn they had RSV. In older or chronically ill adults, the first noticeable sign may instead be breathlessness, wheezing or unusual tiredness.

How long does RSV last in adults?

Most healthy adults recover in 1 to 2 weeks. Congestion and fever usually settle within a week, while cough can linger for two to three weeks without indicating a complication. Older adults and people with heart, lung or immune conditions should expect a slower recovery, and immunocompromised adults may remain unwell, and infectious, for considerably longer. A cough that is worsening after a week warrants a call to a clinician.

RSV vs flu vs COVID: can I tell which one I have at home?

Not reliably. Flu tends to start abruptly with high fever and aches, RSV creeps in with congestion and a lower fever, and COVID varies widely, but these are population tendencies with heavy overlap. Clinicians use a single swab that tests for all three viruses at once. Knowing which you have matters most if you are at higher risk, because flu and COVID have time-sensitive treatments and RSV does not.

Is RSV contagious in adults, and for how long?

Yes. Adults with RSV are typically contagious for 3 to 8 days and may spread the virus a day or two before symptoms begin. The virus travels in droplets from coughs and sneezes and survives on hard surfaces for several hours. People with weakened immune systems can remain infectious for up to four weeks. Handwashing, covering coughs and avoiding close contact with vulnerable people during the first week are the most effective precautions.

Is RSV dangerous for elderly adults?

It can be. Adults over 65 account for the large majority of adult RSV hospitalizations, with CDC estimating 100,000 to 150,000 admissions and 4,000 to 10,000 deaths each year in the US. The danger comes from pneumonia and from flare-ups of existing heart or lung disease. Because fever is often absent in this age group, families should watch for breathlessness, confusion, poor appetite and reduced activity rather than relying on a thermometer.

Who is at risk of severe RSV as an adult?

Risk rises with age and with conditions that reduce physical reserve: COPD, asthma, heart failure, coronary disease, diabetes with complications, chronic kidney or liver disease, severe obesity, weakened immunity from illness or treatment, neurological conditions affecting breathing, and residence in long-term care. Adults aged 75 and older are at highest risk regardless of other conditions. Pregnancy is included in vaccine programs to protect the infant rather than because the parent is at higher risk.

Is there a treatment for RSV in adults?

There is no antiviral approved for routine RSV treatment in adults, so care is supportive: rest, fluids, and symptom relief with over-the-counter products chosen with a pharmacist or clinician. Antibiotics do not work against RSV and are used only for bacterial complications. Adults with asthma or COPD may need their prescribed inhaled treatments adjusted by their clinician. Several oral antivirals are in clinical trials but are not available outside research settings.

Who should get the RSV vaccine according to CDC?

CDC recommends a single dose for all adults aged 75 and older, and for adults aged 50 to 74 who have conditions that raise their risk of severe RSV, including chronic heart or lung disease, diabetes with complications, weakened immunity, severe obesity and nursing-home residence. A separate recommendation covers vaccination during weeks 32 to 36 of pregnancy to protect the newborn. No booster dose is currently recommended. The final decision rests with your clinician.

Can the RSV vaccine give you RSV or cause side effects?

The vaccine cannot cause RSV infection because none of the adult products contains live virus. Common side effects are a sore arm, tiredness, headache and muscle aches lasting a day or two. Post-marketing surveillance has identified a small increased risk of Guillain-Barré syndrome, a rare nerve condition, with the protein-based vaccines, estimated at a few cases per million doses. Your clinician can weigh this against your personal risk from RSV.

When should an adult with RSV symptoms go to the hospital?

Go the same day for shortness of breath at rest, blue or gray lips, chest pain, a racing heartbeat, new confusion, inability to keep fluids down, or an oxygen reading below 92%. Adults over 60 or with heart, lung or immune conditions should contact a clinician early in any respiratory illness, since testing may reveal flu or COVID, which have time-sensitive treatments. Symptoms that improve and then worsen again also need prompt review.

References

• CDC: Symptoms and Care of RSV
• Cleveland Clinic: Respiratory Syncytial Virus (RSV) in Children and Adults
• NHS: RSV vaccine
• MedlinePlus: Respiratory Syncytial Virus Infections

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.