8 RSV Vaccine Side Effects: What to Expect After Receiving Abrysvo, Arexvy, or mRESVIA
Key takeaways:
Arexvy, Abrysvo, and mRESVIA are three respiratory syncytial virus (RSV) vaccines available for older adults. Abrysvo is also approved for pregnant women to help protect their newborn after birth.
Common RSV vaccine side effects include injection site reactions, fatigue, and headache. They’re typically mild and can be managed at home until they resolve within a few days.
While rare, there have been reports of serious side effects, such as Guillain-Barré syndrome, in some people who received an RSV vaccine during clinical trials. But it’s not clear if they were caused by the vaccine.
Table of contents
Each year, respiratory syncytial virus (RSV) leads to outpatient visits, hospitalizations, and death in older adults and young children across the U.S. Fortunately, we now have three RSV vaccines to protect vulnerable groups heading into the fall — Abrysvo, Arexvy, and mRESVIA. All three vaccines are approved for older adults. But Abrysvo can be given to pregnant women to protect newborns after birth.
Abrysvo, Arexvy, and mRESVIA aren’t live vaccines. So it’s not possible to get infected with RSV after you receive your dose. But it’s normal to feel under the weather for a few days afterwards. Headache, fatigue, and soreness at the injection site are a few examples of common side effects.
So what other side effects are possible after receiving Abrysvo, Arexvy, or mRESVIA?
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RSV vaccine side effects at a glance
RSV vaccine side effects are what you’d typically expect from other vaccines. They’re usually mild and should get better within a few days.
Common RSV vaccine side effects include:
Injection site reactions
Feeling tired
Headache
Fever
Nausea
Diarrhea
Underarm swelling or tenderness
Muscle and joint pain
While rare, serious side effects have also been reported after vaccination with Abrysvo and Arexvy. This includes Guillain-Barré syndrome and an abnormal heart rhythm. There was also a report of facial paralysis after vaccination with mRESVIA. But it’s not clear if the RSV vaccines actually cause these side effects. Severe allergic reactions to any of the vaccines are also possible.
Let’s review eight RSV vaccine side effects in more detail below, including how to manage them and when to contact your care team.
1. Injection site reactions
All three RSV vaccines are injected into the deltoid muscle in the upper arm. It’s common to experience injection site reactions, such as redness, pain, and swelling, where your dose was injected. If this happens, it doesn’t mean you’re allergic to the vaccine.
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In general, injection site reactions are mild and only last a few days. Your primary care provider or pharmacist can give you tips on how to manage them after your dose. A few examples include applying an ice pack for redness and swelling or a warm compress for irritation.
Let your care team know if any injection site reactions seem to be getting worse or are not going away.
2. Headache
Headache is a common side effect of Arexvy, Abrysvo, and mRESVIA. However, only a small percentage of people reported headaches that were severe enough to prevent normal daily activities.
If you happen to get a headache after your shot, there are a few things you can do to help yourself feel better, including:
Drinking plenty of fluids to stay hydrated
Reducing stress and doing relaxing activities
Avoiding foods or drinks that might make headaches worse, such as alcohol
Getting plenty of rest
Taking an over-the-counter (OTC) pain reliever, if appropriate
If your headache doesn’t go away within a few days, or seems to be getting worse, call your healthcare professional. And if you’re pregnant, it’s a good idea to check in with your care team regardless. They can rule out a serious condition called preeclampsia and recommend safe medications you can take for a headache.
3. Fatigue
It’s common to feel tired or fatigued after receiving most vaccines, including an RSV vaccine. If this happens to you, take it easy and get plenty of rest. If possible, it can also help to plan ahead and keep your schedule light for a day or two after receiving a dose. You should feel more energetic within a few days.
4. Muscle and joint pain
Muscle and joint pain are also common RSV vaccine side effects, with muscle pain being reported more frequently during clinical trials. For most people, the pain was mild and didn’t interfere with their usual daily activities.
Mild joint pain and achy muscles after getting your shot can be treated at home. For example, you could try applying some ice to your sore muscles for relief. Your primary care provider or pharmacist can also suggest an OTC pain reliever that’s safe for you to take.
Keep in mind that some medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin), aren’t recommended after 20 weeks of pregnancy.
5. Nausea
About 1 out of every 5 pregnant women who received Abrysvo during clinical trials reported nausea. But it’s important to note that this wasn’t much different from those who didn’t receive it (placebo group). A small percentage of older adults receiving Abrysvo also experienced nausea, as well as around 7% of those who got mRESVIA. It wasn’t reported at all with Arexvy.
Similar to other RSV vaccine side effects, nausea should quickly resolve on its own. In the meantime, it may help to eat smaller, more frequent meals and to avoid spicy or fried foods. If you’re pregnant, keep in mind that your nausea may not be from the vaccine. Contact your care team if the nausea doesn’t go away or results in vomiting.
6. Diarrhea
Similar to nausea, pregnant women receiving Abrysvo, as well as some older adults, reported mild diarrhea during clinical trials. But in both cases, diarrhea happened just as frequently in the placebo groups. And diarrhea wasn’t reported at all with Arexvy or mRESVIA.
If you receive an RSV vaccine and develop diarrhea, it should be short lived. Try avoiding spicy, fatty, and fried foods during this time, since they can worsen diarrhea. But if your diarrhea becomes severe or doesn’t go away, contact your healthcare professional. They can help determine the cause and how best to manage it.
7. Fever
As your immune system responds to a vaccine, it’s normal to develop a fever. While it wasn’t common during clinical trials, some people receiving Abrysvo, Arexvy, or mRESVIA reported fever as a side effect.
Most people can manage a fever at home with OTC medications. Your primary care provider or pharmacist can help you choose a safe option to take. And if your fever is from the vaccine, it should quickly resolve on its own. Keep in mind that a longer-lasting fever, along with other cold and flu symptoms, may be from an infection instead.
Although rare, it’s possible to get a high-grade fever after getting Abrysvo, Arexvy, or mRESVIA. If you feel very sick or have a fever of 102.4°F or higher, contact your care team. And if your fever isn’t going away or is getting worse, they can determine the cause and how to treat it.
7. Underarm swelling and tenderness
Underarm swelling and tenderness has been reported by people who received mRESVIA during clinical trials. These symptoms are likely due to swollen lymph nodes in your armpits, which can happen with some vaccines. Underarm swelling was not reported within Arexvy or Abrysvo.
Underarm swelling should resolve within a day or two, and it shouldn’t prevent you from doing normal daily activities. But if your symptoms seem severe or aren’t going away, you should contact your care team for evaluation.
What are the serious side effects of the RSV vaccines?
Some people who received an RSV vaccine during clinical trials experienced serious side effects, although this was very rare. While it’s not clear if they were actually caused by the vaccine, it’s important to be aware of them.
With both Abrysvo and Arexvy, there were a few reports of a serious neurologic condition called Guillain-Barré syndrome (GBS). More research is needed to know if the risk of GBS is higher after getting an RSV vaccine. Symptoms of GBS include muscle weakness, a “pins and needles” feeling, and problems with balance. There was also a report of facial paralysis after vaccination with mRESIA.
Severe allergic reactions (including anaphylaxis) are possible with any vaccine. The risk of this happening is low, but watch out for signs such as rash, swelling in your face or throat, and trouble breathing. Get medical help right away if you notice any of these symptoms.
A few other rare, but serious side effects reported after vaccination include atrial fibrillation (abnormal heart rhythm) and a rare type of brain and spinal cord inflammation.
Are there potential risks for pregnant women?
Preeclampsia is a condition during pregnancy that causes dangerously high blood pressure. Some pregnant women, including those who received Abrysvo and those who did not, developed preeclampsia. But the rate of preeclampsia was slightly higher in the Abrysvo group.
Preeclampsia usually happens around the last month of pregnancy, which is when you would receive Abrysvo. Symptoms can include persistent or severe headaches, vision changes, or swelling in your face or hands. Get immediate medical attention if these develop.
Another possible complication that could happen after getting an RSV vaccine during pregnancy is preterm birth. This is when your baby is born before 37 weeks of pregnancy. During clinical trials, a small increase in preterm births were observed in pregnant women who got Abrysvo. It isn’t clear if the early births happened because of the vaccine, or other reasons.
Talk to your healthcare professional about the potential benefits and risks of receiving an RSV vaccine. They can help you make an informed decision for your specific situation.
RSV vaccine side effects in adults vs. babies
Currently, there are no RSV vaccines approved for babies. But there are immunizations, which provide protection against RSV in a slightly different way. Instead of teaching your immune system to kill a virus with a vaccine, the immunizations provide RSV-fighting antibodies directly to the baby.
There are currently two RSV immunizations available for babies and certain young children: Beyfortus (nirsevimab) and Synagis (palivizumab). Potential side effects include injection site reactions (such as redness, pain, and swelling) and rash. Fever has also been reported with Synagis.
To summarize, RSV vaccine side effects in adults typically include injection site reactions, fatigue, and headache. Nausea is also common with Abrysvo during pregnancy. Babies and young children receiving RSV immunizations can experience side effects such as injection site reactions, rash, and fever.
Frequently asked questions
Yes, the RSV vaccines have been shown to be safe during clinical trials. Like other vaccines, there are some potential side effects to be aware of. Most side effects are mild and resolve within a few days of home care.
Rarely, the RSV vaccine can cause severe allergic reactions that require immediate medical attention. There have also been a few reports of brain and nerve conditions such as GBS. But it isn’t known if these cases were related to the vaccine. Your primary care provider can help you weigh the benefits and potential risks of receiving an RSV vaccine.
If you have had a severe allergic reaction to any ingredients in the RSV vaccines, you shouldn’t receive it. Make sure to discuss all allergies you’ve had in the past with your healthcare professional. They can help you decide whether an RSV vaccine is right for you.
The FDA approved the RSV vaccines within the last year, so researchers are still looking at how long protection from the vaccines lasts. So far, Arexvy and Abrysvo have been shown to protect against RSV for at least 2 years. The mRESVIA vaccine is newer, but has been shown to be about 50% effective after 18 months. The CDC recommends getting only one dose of an RSV vaccine for now.
If you’re eligible, you can get an RSV vaccine at any time. But the best time to get it is before RSV season usually starts. That means rolling up your sleeve in the late summer or early fall (August to October) can help the RSV vaccine give you the most protection.
The bottom line
Abrysvo, Arexvy, and mRESVIA may cause mild side effects that usually go away within a few days. Common examples of respiratory syncytial virus (RSV) vaccine side effects include injection site reactions, fatigue, and headache. While rare, serious side effects, such as Guillain-Barré syndrome (GBS) and facial paralysis, have also been reported.
Many RSV vaccine side effects can be managed at home with fluids, rest, and over-the-counter medications. Contact your healthcare professional if any side effects are severe, getting worse, or won’t go away.
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References
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