How Effective Is The Rsv Vaccine For Older Adults?

New real-world information corroborate nan RSV vaccine offers beardown protection for older adults crossed 2 winters, but item weaker responses successful those pinch compromised immunity and cardiovascular disease.

Study: RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years aliases Older During 2 Seasons. Image credit: Ground Picture/Shutterstock.com

A large-scale multicenter study published successful JAMA revealed that a azygous dose of nan respiratory syncytial microorganism (RSV) vaccine is 58% effective successful preventing RSV-related hospitalization among older adults during 2 viral seasons.

Background

Respiratory syncytial microorganism (RSV) is simply a seasonally prevalent microorganism successful nan United States, causing epidemics each twelvemonth successful nan autumn and winter. The microorganism induces terrible respiratory unwellness and chronic cardiorespiratory conditions successful older adults. An estimated 100,000 to 150,000 RSV-related hospitalizations and 4000 to 8000 deaths hap annually among adults aged 60 years aliases supra successful nan United States.

Three RSV vaccines, including 2 macromolecule and 1 mRNA, person been approved and recommended for older adults to forestall terrible respiratory illness. In June 2023, a azygous dose of nan RSV vaccine was initially recommended for adults aged 60 years and above. The proposal was updated successful June 2024 for each adults aged 75 years aliases older and at-risk adults aged 60 to 74 years, and successful April 2025 for adults aged 50 to 59 astatine higher consequence of terrible RSV infection.

Monitoring RSV vaccines' objective effectiveness and durability against terrible infections and related hospitalization, peculiarly successful high-risk subpopulations, is important for nationalist health. Continuous monitoring is besides captious to find whether vaccine effectiveness is declining owed to mutation-related changes successful viral fitness. 

The Investigating Respiratory Viruses successful nan Acutely Ill (IVY) Network has antecedently assessed nan effectiveness of RSV vaccines successful a divers organization during nan first play of use. The IVY Network is simply a multicenter surveillance web that recruits older adults hospitalized pinch acute respiratory unwellness successful nan United States.

The existent study was designed to measure nan effectiveness of RSV vaccines against hospitalization during 2 viral seasons among older adults astatine higher consequence of processing terrible RSV infections.

Study design

The study organization included 6958 adults aged 60 years aliases supra who were hospitalized pinch acute respiratory unwellness during 2 RSV seasons: betwixt October 1, 2023, and March 31, 2024, aliases October 1, 2024, and April 30, 2025.

Among enrolled participants, 821 (11.8%) were cases (infected only pinch RSV) and 6137 (88.2%) were controls (tested antagonistic for RSV, SARS-CoV-2, and influenza; quality metapneumovirus was allowed, pinch a sensitivity study excluding it). About 7.7% of cases and 15.7% of controls received a azygous dose of RSV vaccine astatine slightest 14 days earlier unwellness onset.

The effectiveness of RSV vaccination successful preventing RSV-related hospitalization was assessed successful nan full study organization and was stratified by nan interval betwixt vaccine receipt and unwellness onset.

Key findings

According to nan study estimates, a azygous dose of nan RSV vaccine is 58% effective successful preventing RSV-related hospitalization among adults aged 60 years aliases supra during 2 viral seasons compared to nary vaccination. The protection against terrible outcomes among hospitalized patients was sustained for 2 years, pinch a 72% vaccine effectiveness against invasive mechanical ventilation aliases death.

The estimated vaccine effectiveness was 69% erstwhile nan vaccine was administered successful nan aforesaid play earlier unwellness onset and 48% erstwhile vaccination occurred successful nan anterior season. Although constituent estimates suggested waning, this quality was not statistically important (P = 0.06).

The estimated vaccine effectiveness during 2 seasons was 30% among immunocompromised adults, importantly little than that among immunocompetent adults (67%). A akin simplification successful vaccine effectiveness was observed among immunocompetent adults pinch cardiovascular illness (56%) compared to those without cardiovascular illness (80%).

The effectiveness of nan vaccines Arexvy (GSK) and Abrysvo (Pfizer) was similar. They were effective against some RSV A and RSV B subtypes.

Study significance

The study highlights nan protective efficacy of a single-dose RSV vaccination against RSV-related hospitalization and terrible in-hospital outcomes among older adults during 2 viral seasons.

The observed simplification successful vaccine effectiveness successful at-risk subpopulations indicates that older adults pinch mean to terrible immunocompromising conditions whitethorn person little first and little durable immune responses to RSV vaccination, highlighting nan request for a shorter revaccination interval.

Among older adults pinch cardiovascular disease, nan observed simplification successful vaccine effectiveness whitethorn beryllium associated pinch nan pro-inflammatory authorities that diminishes immune responses, contributing to accrued susceptibility to RSV infection and perchance inhibiting immune responses aft vaccination. Reduced vaccine effectiveness successful this subpopulation besides highlights nan request for a shorter revaccination interval than that for nan wide older big population.

Existing grounds connected RSV vaccine-specific immune responses suggests that revaccination astatine intervals ranging from 12 to 36 months aft nan superior vaccination tin boost antibody titers, but not to nan aforesaid level arsenic aft nan superior dose. These findings work together pinch nan results of a objective efficacy trial, which demonstrates that older adults reimmunized pinch nan RSV vaccine 12 months aft nan superior vaccination do not summation further protection against RSV-related little respiratory tract illness compared to nary revaccination.

The Advisory Committee connected Immunization Practices has precocious expanded RSV vaccination to adults aged 50 to 59 who are astatine higher consequence of terrible RSV infection. Such reformation of vaccine argumentation for adults highlights nan request for continuous monitoring of vaccine efficacy to accurately qualify waning protection and pass revaccination intervals.

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