RSVpreF

THURSDAY, Oct. 23, 2025 — You may have seen recent news stories reporting that a national data investigation found that routine childhood vaccination is slipping across much of the United States, leaving classrooms and daycares with growing gaps in protection against highly contagious diseases like measles and whooping cough. That’s a warning sign for every family with children — and an even bigger one for children with asthma , whose lungs are more likely to suffer when infection strikes. Allergists are also immunologists. We are physicians trained to evaluate vaccine reactions and ingredients. As an allergist and executive medical director of the American College of Allergy, Asthma & Immunology (ACAAI) , I often explain to my patients and their parents why vaccines remain one of the best tools to keep vulnerable lungs healthy, what “herd immunity” really means and how to get reliable, allergy-informed guidance. Herd (community) immunity means enough people are immune, through vaccination or prior infection, that a virus struggles to spread, and those who can’t be vaccinated or have weaker immune systems are still protected. Vaccination rates need to stay between about 92% and 95% to stop a virus from spreading. When rates fall below that level, outbreaks become far more likely. Measles is one of the most contagious infections known. But the percentage of U.S. kindergarteners who have had two doses of the Measles Mumps Rubella vaccine (MMR ) fell from about 95% in 2019–20 to 92.7% in 2023–24, leaving hundreds of thousands of children more exposed. The consequences are already apparent: During the 2025 West Texas measles outbreak , 99 people were hospitalized and two school-aged children died from a largely preventable disease. The American Academy of Pediatrics (AAP) emphasizes the importance of following the recommended childhood immunization schedule to close those risk gaps. Vaccines don’t just protect you: They also protect your child’s classmates and your immunocompromised neighbor and help your child with asthma breathe easier. Every vaccine given in the U.S. undergoes rigorous clinical testing and ongoing safety surveillance. Guidance is updated annually to reflect the latest evidence. Keep in mind the following about vaccines for respiratory illnesses: Influenza (flu) vaccine: Everyone 6 months and older should get a flu shot each year. People with asthma are at higher risk of severe flu complications: Flu can trigger asthma attacks, worsen symptoms and lead to pneumonia and hospitalization. Annual vaccination reduces those risks. Pneumococcal vaccines: Pneumococcal disease is especially dangerous for people with chronic lung disease, including asthma. A four-dose series of PCV15 or PCV20 is recommended for children under 5 , and expanded use of PCV20 (or PCV15 + PPSV23) is recommended for adults , including those between 19 and 49 years of age with asthma. MMR: A first dose of the MMR vaccine is recommended between 12 and 15 months of age, and a second dose at least 28 days later. (It is often given between 4 and 6 years of age.) RSV protection : The AAP recommends protecting infants from RSV via maternal vaccination or infant immunization with nirsevimab during their first RSV season , which is typically from September through January. Pregnant women can receive the RSV vaccine (RSVpreF) between 32 and 36 weeks of gestation. This timing helps to pass protection to the infant before birth. The vaccine is recommended for pregnant women who do not have a planned delivery within the next two weeks and have not received the maternal RSV vaccine during the previous RSV season. Pregnant women can receive the RSV vaccine (RSVpreF) between 32 and 36 weeks of gestation. This timing helps to pass protection to the infant before birth. The vaccine is recommended for pregnant women who do not have a planned delivery within the next two weeks and have not received the maternal RSV vaccine during the previous RSV season. Infants under 8 months of age should receive monoclonal antibody immunization (nirsevimab or clesrovimab) during their first RSV season, ideally within the first week of life if born between October and March. This is especially if their mother was not vaccinated against RSV during pregnancy. Infants under 8 months of age should receive monoclonal antibody immunization (nirsevimab or clesrovimab) during their first RSV season, ideally within the first week of life if born between October and March. This is especially if their mother was not vaccinated against RSV during pregnancy. Children aged 8 through 19 months at increased risk for severe RSV disease should receive nirsevimab at the start of their second RSV season. AAP defines high risk as infants with chronic lung disease, those with compromised immune systems and other groups. Nirsevimab can be given at the same time as other routine childhood vaccines. Children aged 8 through 19 months at increased risk for severe RSV disease should receive nirsevimab at the start of their second RSV season. AAP defines high risk as infants with chronic lung disease, those with compromised immune systems and other groups. Nirsevimab can be given at the same time as other routine childhood vaccines. Large-scale research also confirms that vaccines do not cause asthma or allergic disease. A 2021 meta-analysis of more than 5,000 children found no link between routine childhood vaccines and later asthma, eczema or hay fever. If you have a history of hives, wheeze after a prior vaccination or have questions about ingredients (e.g., gelatin, PEG), an allergist can test, choose alternatives, adjust the timing of certain vaccines and vaccinate under supervision when needed. Most people with allergies can be vaccinated safely, with only a small number needing special evaluation. True vaccine allergies are extremely rare . Decades of evidence also show people with egg allergy can receive any age-appropriate flu vaccine without special precautions. Respiratory infections are among the most common triggers of asthma flare-ups. Preventing those infections through flu, pneumococcal and other routine childhood immunizations lowers the chance of an asthma attack, emergency visits and complications. For example, a 2023 study found flu vaccination lowered hospital visits among people with asthma by nearly 60%. When you schedule flu shots for the whole family, discuss your options with your provider first. The live attenuated influenza vaccine (LAIV) is commonly known as the nasal spray vaccine, and it is generally not recommended for people with asthma due to the risk for wheezing. Inactivated vaccines, however, are safer for people with asthma — including those on asthma biologics like dupilumab. Staying up to date on vaccines is part of good asthma control. Evidence you can trust: ACAAI’s patient resources summarize the importance of vaccines for people with allergies and asthma and what the science shows about vaccine safety . Evidence you can trust: ACAAI’s patient resources summarize the importance of vaccines for people with allergies and asthma and what the science shows about vaccine safety . Find an allergist: Use ACAAI’s allergist locator to get personalized guidance on vaccine timing, product choice and managing prior reactions. Find an allergist: Use ACAAI’s allergist locator to get personalized guidance on vaccine timing, product choice and managing prior reactions. Actionable plans: Allergists coordinate with your pediatrician or primary care clinician to keep you on schedule, document any precautions and reduce barriers (for example, scheduling same-day asthma and immunization visits). Actionable plans: Allergists coordinate with your pediatrician or primary care clinician to keep you on schedule, document any precautions and reduce barriers (for example, scheduling same-day asthma and immunization visits). Remember, vaccines are part of everyday asthma control alongside inhalers and management of triggers. When your family, alongside kids at your child’s school, stays up to date on vaccines, it all helps every person with asthma breathe easier. About the expert Dr. Todd Mahr is the executive medical director at the American College of Allergy, Asthma & Immunology.

The American Lung Association is planning to create a new educational resource on vaccines for people living with lung cancer. Moderna is backing the American Lung Association’s (ALA’s) call for people with lung diseases to get vaccinated for the upcoming respiratory virus season.The biotech, which sells vaccines against COVID-19 and respiratory syncytial virus (RSV), is supporting a new campaign from the ALA to communicate the importance of staying up to date on recommended vaccinations. The ALA said in a Wednesday announcement that it is particularly keen to reach the more than 35 million people living with chronic lung disease in the U.S. and the 235,000 people diagnosed with lung cancer each year.People with those conditions are at a higher risk of severe illness. Vaccine use recommendations reflect the risks: RSV vaccines, for example, are recommended for use in people aged 50 to 74 who are at higher risk of severe illness, including those who have chronic lung disease. Otherwise, the recommended age is 75 and older.  The ALA campaign also covers vaccines against flu and COVID-19. Annual flu shots are recommended for everyone aged 6 months and older, while the COVID-19 vaccine advice changed recently, with the Advisory Committee on Immunization Practices (ACIP) recommending individual-based decision-making. ACIP noted that the risk-benefit profile of vaccines is most favorable in people with COVID-19 risk factors. Through the campaign, the ALA will raise awareness about surveillance trends and the expected severity of the respiratory virus season. The advocacy group is also planning to create a new educational resource on vaccines for people living with lung cancer and to hold a chronic lung disease webinar.The ALA’s focus on severity follows a bad flu season. Last winter was the first high-severity season since the 2017-2018 season, with the 2024-2025 season classified as high severity across children, adults and older adults.  Moderna is active against all the viruses that the ALA is targeting, although it has yet to win approval for a flu shot that recently passed a phase 3 test. The flu vaccine program is intended to complete Moderna’s respiratory portfolio and “create basically a cash cow,” CEO Stéphane Bancel said at a Morgan Stanley event last month. Bancel said he believes the vaccines can be commercialized with limited investment.“We’re not selling, detailing to doctors for the flu vaccine or the combo vaccine,” Bancel said. “We're directly negotiating with CVS and Walgreens and Walmart and all the big retailers ... so we can handle those products without adding salespeople.”