Q&A: RSV vaccination lowers risk for hospitalization in older patients
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Key takeaways:
- RSV vaccination lowered the risk for RSV-associated hospitalization by 75% among older adults.
- The CDC is hopeful that the new data will increase vaccine uptake this year.
During their first season in use, respiratory syncytial virus vaccines reduced the risk for RSV-associated hospitalization by 75% among adults aged 60 years or older, according to a study.
“We’re hopeful that these findings provide increased evidence of their effectiveness against more severe RSV disease, and that it helps increase uptake of the vaccine this season,” Diya Suri, MD, a medical officer in the CDC’s Coronavirus and Other Respiratory Viruses Division, told Healio.
Uptake of the first two RSV vaccines ever approved was low last season, which some experts have attributed to the CDC’s recommendation that older adults “may” receive a vaccine based on shared clinical decision-making, rather than a stronger “should” recommendation.
Experts are hopeful that the approval of a third vaccine option, from Moderna, and newly strengthened CDC recommendations could improve uptake for the 2024-2025 respiratory disease season.
For their study, Suri and colleagues analyzed data on nearly 3,000 adults aged 60 years or older — 12.3% of whom had RSV and 87.7% of whom did not — who were hospitalized with acute respiratory illness at one of 24 hospitals in 19 U.S. states between Oct. 1, 2023, and March 31, 2024.
Among study participants, 2.5% of case patients and 24.2% of controls had been vaccinated against RSV. Compared with unvaccinated patients, vaccinated patients tended to be older, immunocompromised, had outpatient visits in the previous year and resided in communities with lower Social Vulnerability Scores.
The researchers calculated vaccine effectiveness (VE) against RSV-associated hospitalization to be 75% (95% CI, 50%-87%). VE was similar among both adults aged 60 to 74 years and adults aged 75 years and older.
We asked Suri about the significance of the data and what it means for clinicians and patients. Her answers have been lightly edited for clarity and length.
Healio: Were this study’s findings a surprise?
Suri: The clinical trials did not evaluate an outcome of RSV-associated hospitalization, and these findings help build on what was demonstrated in the clinical trials. They evaluated an outcome of symptomatic lower respiratory tract disease. These data expand on those findings to demonstrate that RSV vaccination reduced the risk of hospitalization by 75% among those vaccinated compared with those who were not vaccinated.
Healio: The CDC in June made new recommendations for people aged 60 to 74 years and for people aged 75 years and older. Do these data support the new recommendations?
Suri: Yes. These were among the results that were presented to the Advisory Committee on Immunization Practices in June when the committee provided updated recommendations that all adults aged 75 years and older — and those age 60 to 74 years at increased risk for RSV disease, including people with chronic conditions and chronic lung disease and chronic cardiovascular disease —receive a vaccine. These results demonstrate support for those recommendations, in part because they also include patients who have those conditions and are older and at increased risk of cardiovascular disease.
Healio: With respiratory season starting, and new vaccines for COVID-19 and influenza also on the way, when is the best time for people to receive an RSV vaccine?
Suri: Fall season is upon us, and RSV disease is a seasonal virus that circulates, typically, from October through March or April, so this is a good month to be getting RSV vaccines. I’ll also add that, currently, the vaccine is recommended as a single dose, so only those who have not yet received an RSV vaccine are eligible to receive it this coming season.
Healio: What is the takeaway for clinicians from this study, especially considering that it appears to line up with the new CDC recommendations?
Suri: These findings support that all adults aged 75 years and older receive the vaccine, and that those aged 60 to 74 years with chronic cardiovascular disease, chronic lung disease and patients in nursing homes — among a broader list of underlying conditions that are specified on the CDC website, as well as in an MMWR report released last month — should receive a RSV vaccine.
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