Respiratory syncytial virus (RSV) vaccine clinical trials reported higher frequencies of atrial fibrillation in intervention compared with control groups. In this large, population-based, propensity-matched study, we found that RSV vaccine was not associated with increased risk of new-onset or recurrent atrial fibrillation within 1-42 days, compared with influenza or tetanus, diphtheria, and pertussis (Tdap) vaccines.