Older Adults with RSV Vaccine Experienced Less Infections, Hospitalizations | CHEST 2024

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Researchers addressed the prevalence of RSV and its associations with immunization, infection, and hospitalization amongst older adults.

In an abstract presented at the American College of Chest Physicians 2024 Annual Meeting, researchers found that older adults who were vaccinated against respiratory syncytial virus (RSV) were less likely to experience RSV infection and hospitalization, compared with elderly individuals who were not vaccinated.1 Their findings provide evidence of the RSV vaccine’s effectiveness amongst older adults who may be immunocompromised, leading researchers to suggest further attention of RSV immunization within the elderly population.

“Annually, in the [US] alone, RSV leads to 60,000-160,000 hospitalizations and 6000-10,000 deaths among adults over 65 years. Given this, understanding RSV prevalence dynamics, its correlation with hospitalization rates, and the effects of immunization strategies are critical for health care systems and policymakers, especially following the FDA approval of RSV vaccines for adults over 60 years in May 2023,” wrote authors of the abstract.1

Key Takeaways

  • Researchers addressed RSV and its associations with immunization, infection, and hospitalization amongst older adults.
  • They found risks of RSV incidence and hospitalization were lower in the vaccinated group compared with those who were unvaccinated.
  • Just over a year since its approval, GSK's Arexvy is the clinical standard for keeping older adults protected against RSV.

Indeed, the very first RSV vaccine was announced on May 3, 2023, with the FDA giving approval to GSK Biologicals’ Arexvy to treat lower respiratory tract disease.2 However, with Arexvy’s recent approval less than 2 years ago, the vaccine is not instantly catching on amongst the elderly population.

According to a survey conducted by the National Foundation for Infectious Diseases, among the participants who have been recommended the RSV vaccine, just 21% said they plan to definitely receive it this winter season. Furthermore, 44% of respondents said they do not plan to or are unsure about receiving the vaccine.3

“[RSV] remains a global public health concern, particularly impacting vulnerable populations like infants, the elderly, and immunocompromised individuals. RSV infections are a leading cause of respiratory illness, resulting in significant hospitalizations, morbidity, and health care costs, especially during seasonal outbreaks,” continued authors of the study abstract.1

The very first RSV vaccine was announced on May 3, 2023, with the FDA giving approval to GSK Biologicals’ Arexvy. | image credit: kitsawet / stock.adobe.com

The very first RSV vaccine was announced on May 3, 2023, with the FDA giving approval to GSK Biologicals’ Arexvy. | image credit: kitsawet / stock.adobe.com

READ MORE: RSV: Clinicians Discuss Strategies to Deal with Vaccine Resistance

With perceivable uncertainty surrounding the rather new-to-market RSV vaccine, researchers hosted a session titled “Beyond the Breath: Transforming Outpatient Pulmonary Care and Vaccination Strategies” at the American College of Chest Physicians 2024 Annual Meeting. To assess RSV vaccination, infection, and hospitalization rates, researchers analyzed individuals 60 and over from May 1, 2023, to March 20, 2024. RSV infection and hospitalization rates were the researchers’ primary outcomes.

There was a total of 226,690 individuals eligible for the RSV vaccine included in the study. They were then separated into 2 groups; the first including 10,295 (4.5%) vaccinated participants and the other with 216,395 (95.5%) unvaccinated participants.1

Regarding rates of infection amongst each population, only 5 (0.05%) RSV cases were identified in the vaccinated group, compared with 205 (0.09%) cases in the unvaccinated group. Despite finding no statistically significant association between vaccination and RSV incidence, the results “indicated a protective effect of the vaccine, reducing the risk and odds of RSV occurrence in vaccinated individuals by approximately 50%.”1

Furthermore, highlighting the RSV vaccine’s efficacy, the vaccinated group did not experience any hospitalizations, while the unvaccinated group had a total of 95 (0.04%).

The researchers noted that risk of RSV incidence or hospitalization is not statistically significant in either population. While those vaccinated against RSV showed more successful results than those who were unvaccinated, the slim proportion of hospitalized and infected participants in both groups was underwhelming.

But by the study’s conclusion, researchers agreed that staying vaccinated against RSV as an adult over 60, or an individual who is immunocompromised, is the best suggestion to keep overall respiratory health in check, especially throughout peak respiratory illness season at the end of each year.

“In this retrospective population-based electronic analysis, RSV vaccination correlated with reduced infection and hospitalization risks compared to the unvaccinated group, although statistical significance was not attained…These findings support expanding RSV immunization strategies in older adults and special consideration for adults who are chronically immunosuppressed to enhance clinical outcomes and decrease health care burdens,” concluded the authors.1

READ MORE: Cost-Benefit Analysis Favors RSV Vaccination for Older Adults

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References
1. Rallabhandi SSH, Salman A, Schultz B, et al. Understanding the current prevalence of RSV: Exploring associations with immunization, infection and hospitalization trends. Presented at: American College of Chest Physicians 2024 Annual Meeting; October 6-9, 2024; Boston, MA. Poster 4507.
2. FDA approves first respiratory syncytial virus (RSV) vaccine. FDA. May 3, 2023. Accessed October 14, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-first-respiratory-syncytial-virus-rsv-vaccine
3. 2024 national survey: Attitudes and behaviors about influenza, COVID-19, respiratory syncytial virus, and pneumococcal disease. National Foundation for Infectious Diseases. September 25, 2024. Accessed October 14, 2024. https://www.nfid.org/resource/2024-national-survey-attitudes-and-behaviors-about-influenza-covid-19-respiratory-syncytial-virus-and-pneumococcal-disease/
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