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June 22, 2023
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CDC advisors recommend older adults consider RSV vaccination

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Key takeaways:

  • The CDC’s ACIP recommended people aged 60 years or older talk to their doctors about getting vaccinated against RSV.
  • Data showed the two approved RSV vaccines remained effective into a second RSV season.

CDC vaccine advisors said Wednesday that older adults in the United States should talk to their physicians about getting vaccinated against respiratory syncytial virus.

In two separate votes, the Advisory Committee on Immunization Practices supported recommendations saying that people aged 60 years or older “may receive” one of the two RSV vaccines recently approved by the FDA — the first two RSV vaccines ever available — in consultation with their physician.

IDN0623ACIP_RSV_Graphic_01_WEB
Data derived from GSK, Pfizer.

They voted 13-0 with one abstention in favor of the recommendation for people aged 60 to 64 years, and 9-5 in support of the recommendation for adults aged 65 years or older.

‘May’ vs. ‘should’

The language of the recommendation — that older patients “may receive” an RSV vaccine — is not as strong as saying they “should” receive one, which the ACIP has done for many other vaccines.

The committee instead chose to recommend that RSV vaccination in older adults be based on “shared clinical decision-making” — a designation it has applied to recommendations in the past addressing meningococcal B, hepatitis B, HPV and pneumococcal vaccination in different age groups.

“Generally,” the CDC says, “ACIP makes shared clinical decision-making recommendations when individuals may benefit from vaccination, but broad vaccination of people in that group is unlikely to have population-level impacts.”

The votes on Wednesday were based on data presented by the vaccine manufacturers, GSK and Pfizer, showing the efficacy of their vaccines over the course of two RSV seasons.

Data shared by GSK showed that vaccine efficacy in preventing severe disease defined by three or more symptoms was 94.1% at the end of the first RSV season and fell to 84.6% through the middle of the second in older adults. Similarly, data shared by Pfizer showed that its vaccine was 88.9% effective in the first season and 78.6% effective through the middle of a second RSV season in older adults.

GSK’s Arexvy became the first RSV vaccine ever approved by the FDA on May 3. The agency approved Pfizer’s Abrysvo on May 31.

New recommendations for flu, polio

The ACIP also made recommendations for influenza and polio vaccination during Wednesday’s meeting.

The committee voted 14-0 to recommend that people aged 6 months or older with an egg allergy can receive any influenza vaccine — egg based or non-egg based — that is otherwise appropriate for them, removing any remaining safety measures for this population.

Additionally, members voted 14-0 that adults aged 18 years or older who are known or suspected to be unvaccinated or incompletely vaccinated could complete a primary vaccine series with inactivated polio vaccine (IPV), and 14-0 that adults who have received a primary series of trivalent oral polio vaccine or IPV in any combination and who are at an increased risk for poliovirus exposure may receive another dose of IPV.

Reference:

CDC. ACIP presentation slides: June 21-23, 2023. https://www.cdc.gov/vaccines/acip/meetings/slides-2023-06-21-23.html. Last reviewed June 22, 2023. Accessed June 22, 2023

CDC. ACIP shared clinical decision making recommendations. https://www.cdc.gov/vaccines/acip/acip-scdm-faqs.html. Last reviewed Feb. 10, 2020. Accessed June 22, 2023.