Underrepresented populations, those with lower income at higher risk for severe RSV
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Key takeaways:
- About one in two adults aged 60 years and older had at least one diagnosed risk factor for severe RSV.
- Undiagnosed RSV risk factors were more common in certain diverse populations vs. white adults.
Older adults from underrepresented populations and those with lower incomes were more likely to have risk factors for severe respiratory syncytial virus disease, a study showed.
The findings suggest that targeting respiratory syncytial virus (RSV) vaccination in at-risk populations could help address health disparities, according to researchers.
In June 2023, the CDC’s Advisory Committee on Immunization Practices recommended that adults aged 60 years and older talk to their physicians about getting vaccinated against RSV.
Currently, the FDA is reviewing GSK’s adjuvanted RSVPreF3 vaccine (Arexvy) for use in adults aged 50 to 59 years who are at increased risk for RSV disease, Emily K. Horn, the associate director of health economics and outcomes research at GSK, told Healio.
“To support equitable RSV vaccination among at-risk adults, it is important to understand disparities in chronic underlying medical conditions associated with increased risk for severe RSV disease,” Horn said.
Horn and colleagues conducted a retrospective, cross-sectional analysis with 2011-2020 National Health and Nutrition Examination Survey data to determine the prevalence of diagnosed and undiagnosed risk factors for severe RSV by race, ethnicity and income.
Specifically, Horn and colleagues assessed the prevalence of 10 risk factors for RSV disease: diabetes, asthma, stroke, coronary heart disease, angina pectoris, COPD, congestive heart failure, myocardial infarction, renal disease and liver disease.
The researchers said they focused on adults aged 50 to 59 years and 60 years and older “because of ongoing RSV vaccination policy discussions in these age groups.”
The participants’ income was reported as the poverty-income ratio (PIR), with a PIR of less than 1 representing family incomes below the poverty level.
Overall, 31.4% of adults aged 50 to 59 years and 46.9% aged 60 years and older had one or more diagnosed risk factors for severe RSV disease.
The prevalence of risk factors was higher among Mexican American and other Hispanic adults, as well as non-Hispanic Black adults, compared with non-Hispanic white adults aged 50 to 59 years (34.1%-36.9% vs. 29.9%) and those aged at least 60 years (50.4%-54% vs. 44.9%).
There was also a higher prevalence of diagnosed risk factors among adults with a PIR of less than 4 vs. those with a PIR of 5 or more, according to the researchers.
Risk factors were also more commonly undiagnosed in underrepresented populations. For example, the researchers said the prevalence of undiagnosed diabetes was twice as high among Mexican American and other Hispanic adults, non-Hispanic Black adults and non-Hispanic Asian adults compared with non-Hispanic white adults aged 50 to 59 years (7%-8.5% vs. 3.5%) and those aged at least 60 years (9.9%-12.1% vs. 5.6%).
Additionally, on average, Mexican American and other Hispanic adults and non-Hispanic Black adults were diagnosed with one or more risk factors at least 4 years earlier compared with non-Hispanic white adults (mean age, 36.8-36.9 years vs. 41.2 years).
Adults with a PIR of less than 1 were diagnosed with one or more risk factors at least 5 years earlier than those with a PIR of 5 or greater (mean age, 35.1 years vs. 40.8 years).
“Primary care providers need to be knowledgeable about these disparities in risk factors for severe RSV disease, initiate discussions with their patients about RSV vaccination and provide strong recommendations for vaccination where appropriate to help protect these groups of higher risk adults from RSV infection and severe outcomes,” Horn said.
Future research, she added, should focus on disparities in severe RSV-related outcomes, RSV vaccination uptake and implementation across population groups, “as well as opportunities to improve vaccination coverage equitably among adults.”
For more information:
Kate Kanaby can be reached at kate.l.kanaby@gsk.com.
Perspective
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In brief, the results are expected and are in concert with a similar study that just was completed locally. An array of social issues such as less access to medical care, crowding at home and lower income can predispose to more frequent and more serious RSV and other respiratory infections. It’s all the more important to identify and reach out to such subpopulations in the U.S. Primary care doctors and their staff likely will have to take more time with such patients to educate and reassure them about the value of immunization.
Adults older than age 60 and those who have chronic medical issues are recommended to receive an RSV vaccine, along with women who will deliver babies during the annual RSV season.
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Horn E, et al. Disparities in Risk Factors for Severe Respiratory Syncytial Virus Disease among Adults in the United States. Presented at: NFID Annual Conference on Vaccinology Research; May 8-10, 2024.
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