The season of never-ending sneezing and stuffy noses is underway, sending Americans to pharmacy lines in hopes of keeping illness at bay with yearly shots.

While flu and COVID-19 vaccines are an annual given for many people, the RSV vaccine isn't quite as universal. Many people associate the virus with babies and young children, but it is more common than many realize, often misdiagnosed as a cold or flu.

After a tumultuous year of changing vaccine guidance and concerns about access, RSV immunization recommendations have remained unchanged. Here's what to know about who should get an RSV shot and where to find one for low or no cost.

What is RSV and who is at risk?

Respiratory syncytial virus is a common respiratory illness named after the virus that causes it. It infects the nose, throat and lungs, causing cold-like symptoms. Its similar presentation to other illnesses like cold or flu can make it hard to identify, but it generally causes only mild symptoms in healthy people.

Severe illness is most commonly associated with babies and young children, who have underdeveloped immune systems and smaller airways more likely to get inflamed and cause breathing trouble, according to the Cleveland Clinic.

Adults 65 and older and people with compromised immune systems are also at increased risk of developing complications like bronchiolitis (inflammation of the small airways in the lungs) and pneumonia.

RSV is contagious and spreads in the fall and winter, usually peaking in December and January, according to the CDC. In cases of severe illness, hospitalization may be required.

In adults and older children, symptoms are similar to other common respiratory illnesses, including cough, runny or stuffy nose, trouble breathing, sore throat, headache, fatigue, fever and loss of appetite. It can look a little different in infants and young children, with symptoms including fussiness, irritability, difficulty breathing, and loss of appetite.

Signs of more severe illness include worsening shortness of breath, wheezing, shallow breathing, struggling to drink enough liquids and blueish skin, lips or nails.

Who should get an RSV vaccine?

The RSV vaccine is recommended by the CDC for all adults over 75, adults over 50 with increased risk, infants and pregnant women.

Anyone aged over 75 can get the RSV vaccine at any time, though the CDC encourages getting the shot in late summer or early fall to prepare for respiratory illness season. Adults aged 50-74 who are at increased risk due to medical issues like chronic heart or lung disease, weakened immune system, or living conditions like staying in a nursing home, should also get immunized around the same time.

Babies can be immunized in one of two ways: a vaccine given during pregnancy or an RSV antibody given directly to infants.

The maternal RSV vaccine is given during weeks 32-36 of pregnancy, allowing the mother's body to develop and pass on antibodies that protect the baby for approximately six months after birth.

An infant RSV antibody shot is recommended for all babies younger than 8 months born to mothers who did not get the vaccine during pregnancy. A dose of the antibody shot should be given to babies shortly before the RSV season, or within one week after birth if born during October through March in most of the U.S, according to the CDC. Some babies at higher risk (such as those born prematurely) may need an additional dose between 8-19 months of age.

People who plan to be in frequent and close contact with small children, older people, or immunocompromised people during respiratory season should also speak with their doctor about getting vaccinated.

Where to get an RSV shot

Pharmacies are the most common place American adults turn to for seasonal vaccines. CVS and Walgreens, two of the largest chains, offer vaccine appointments online, as well as accepting walk-ins. Both offer the option to receive multiple vaccines at once, and the cost of immunization at these pharmacies is covered entirely by most insurance companies.

You should check with your insurance provider if you have questions about costs.

Children who are uninsured or underinsured, Medicaid-eligible or of American Indian or Alaska Native descent can receive the vaccine for free through the CDC's Vaccines for Children (VFC) Program. You do not have to show any proof that your child is eligible for free vaccines beyond certifying their qualifications to the health care professional giving it.

Adults who are uninsured or underinsured or who cannot otherwise afford the vaccine are also eligible for free and low-cost assistance programs. Those seeking an RSV shot can visit Vaccines.gov to find the closest locations to get the shot. Low and no-cost options are available at doctors' and healthcare providers' offices, pharmacies, Health Resources & Services Administration (HRSA)-supported health centers and via employers, schools and community organizations.

As of October 1, 2023, most people with coverage from Medicaid and the Children's Health Insurance Program (CHIP) will be guaranteed coverage of all vaccines recommended by the Advisory Committee on Immunization Practices at no cost to them.

This article originally appeared on USA TODAY: RSV season is here. Who should get a vaccine and where to find one