RSV in Adults: Symptoms, Who Is at Risk, Treatment and the RSV Vaccine
Written by Cherlie Joseph, MSN, FNP-BC · Medically reviewed by Naurah Gaspard, DNP, FNP-C, FNP-BC · Updated November 2026
In most healthy adults, RSV feels like a bad cold and clears in 1 to 2 weeks with rest and fluids. It can turn serious in adults 75 and older and in people with heart or lung disease or a weakened immune system. There is no antiviral pill for RSV in adults, so prevention with a one-time vaccine matters most for people at higher risk.
In this guide
What RSV is and how it spreads
Respiratory syncytial virus (RSV) is a common winter virus. Most people catch it many times over a lifetime, and immunity from past infections fades, so adults keep getting it. It spreads through coughs and sneezes, close contact, and by touching surfaces like doorknobs or phones and then your eyes, nose or mouth.
People are usually contagious for 3 to 8 days, starting a day or two before they feel sick. In Florida, RSV season tends to start earlier and last longer than in the rest of the country, so cases can show up well before the winter holidays.
RSV symptoms in adults
Symptoms usually start 4 to 6 days after exposure and come on in stages rather than all at once. Common symptoms include:
- Runny or stuffy nose and sneezing
- Sore throat and headache
- Cough, which can linger for a couple of weeks
- Low fever (many adults have none)
- Tiredness and low appetite
- Wheezing, especially in people with asthma or COPD
RSV looks a lot like a cold, flu or COVID. The only way to know for sure is a test. Many urgent care clinics and labs now run combined tests for flu, COVID and RSV, which can help when it changes the plan, for example if you might qualify for flu or COVID antivirals.
| Feature | RSV | Flu |
|---|---|---|
| Onset | Gradual, over a few days | Sudden, often within hours |
| Fever | Low or none | Often high, with chills |
| Body aches | Mild | Often severe |
| Antiviral pill for adults | None | Yes, if started early |
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RSV can lead to pneumonia, and it can make existing conditions flare. Adults more likely to get seriously ill include:
- Adults 75 and older
- Adults 50 and older with chronic heart disease (such as heart failure) or lung disease (such as COPD or asthma)
- People with a weakened immune system from cancer treatment, an organ transplant or certain medicines
- People with diabetes complications, chronic kidney or liver disease, or severe obesity
- People who live in a nursing home or long-term care facility
If you fall into one of these groups, it's worth checking in with a provider early in the illness rather than waiting to see how things go.
How RSV is treated
There is no RSV antiviral pill for adults, and antibiotics don't work on viruses. Treatment focuses on comfort and watching for warning signs:
- Rest and fluids. Aim for pale yellow urine. Warm broth and tea count.
- Fever and aches: acetaminophen or ibuprofen, following the label and any limits your provider has given you.
- Congestion: saline spray or rinses, a cool-mist humidifier, and steam from a warm shower.
- Wheezing: if you already have asthma or COPD, use your rescue inhaler as prescribed and let your provider know if you need it more than usual.
Most adults start feeling better within a week, though the cough can hang on longer. A provider may prescribe treatment if a bacterial infection like pneumonia or a sinus infection develops on top of RSV.
The RSV vaccine: who should get it
Three RSV vaccines are licensed for adults in the US: Arexvy (GSK), Abrysvo (Pfizer) and mResvia (Moderna). The CDC does not prefer one over another. Current CDC recommendations are:
- Everyone 75 and older should get one dose.
- Adults 50 to 74 at increased risk of severe RSV, such as those with chronic heart or lung disease, a weakened immune system or who live in a nursing home, should get one dose.
RSV vaccination is not yearly. It's one dose for now, and protection lasts at least two seasons. If you've already had one, you don't need another at this time. Late summer to early fall is the best time to get it, but you can get it any time of year. Most pharmacies give it, and Medicare Part D generally covers it. Common side effects are a sore arm, tiredness, headache and muscle aches for a day or two.
Get in-person care or call 911 if you have:
- Trouble breathing, fast breathing or shortness of breath at rest
- Bluish or gray lips, face or fingernails
- Chest pain or pressure
- New confusion, extreme sleepiness or trouble waking up
- Signs of dehydration, such as very little urine or dizziness when standing
- Symptoms that get much worse after starting to improve
Frequently asked questions
How long does RSV last in adults?
Most healthy adults feel better in 1 to 2 weeks. A dry cough can linger for a few weeks after other symptoms fade. Older adults and people with lung disease may take longer to recover.
Can adults get RSV more than once?
Yes. Immunity after RSV wears off, so adults can be infected again, even in the same season. That's one reason the vaccine is recommended for people at higher risk.
Do I need an RSV vaccine every year?
No. The CDC currently recommends a single dose for eligible adults, not a yearly shot. If you've already had an RSV vaccine, you don't need another one right now.
Sources
Keep reading
- Cold vs Flu vs COVID: Symptoms Compared
- Bronchitis vs Pneumonia: Key Differences
- Cough That Won't Go Away: 8 Common Causes
- Browse all conditions and treatments A to Z
Sick and want a nurse practitioner's opinion today?
$79 visit, no appointment needed. Adults 18+ in FL, NM, OR and WA.
Start a cold & flu visit →
Cherlie Joseph, MSN, FNP-BC
Board-certified family nurse practitioner licensed in Florida, caring for adults online at OurTopClinic. Meet our providers.
This article is for general education and is not a substitute for medical advice. Treatment, including any prescription, is decided by a licensed provider after reviewing your health history. OurTopClinic is not for emergencies; if you have a medical emergency, call 911. OurTopClinic serves adults located in Florida, New Mexico, Oregon and Washington. Learn more at ourtopclinic.com.
