Older and Immunocompromised Adults Advised to Get RSV Vaccine

The Centers for Disease Control and Prevention (CDC) advised older and immunocompromised adults in the United States to get the newly available respiratory syncytial virus (RSV) vaccine. The CDC statement, published on June 29, 2023, emphasizes the importance of shared clinical decision-making when evaluating vaccine use.

The most recent RSV season has been an essential topic of conversation, as the spike in infection rates was more significant than in previous years. While the virus is relatively harmless in healthy adults — characterized by mild, flu-like symptoms, it can be fatal for some patient populations.

Infants, young children, older adults, and immunocompromised individuals are at the highest risk of severe RSV infections. For example, the American Lung Association notes that RSV is the most significant contributor to infant hospitalizations.

According to the CDC, RSV causes 60,000–160,000 hospitalizations in the US yearly among elderly patients over 60 years old. In addition, this viral infection can contribute to up to 10,000 deaths annually across this patient population.

Until recently, healthcare professionals did not have a vaccine available to prevent RSV in patients, relying on sound public health practices, such as hand washing, to minimize infection rates. However, recently, the FDA approved the first RSV vaccine for use in older adults.

GSK secured the first approval on May 3, 2023, beating its competitor, Pfizer, to the punch. For a dual-component vaccine, GSK’s vaccine, Arexvy, comprises a recombinant subunit perfusion RSV F glycoprotein antigen (RSVPreF3) and an As01Ea adjuvant.

Ongoing clinical trials using data from the last RSV season suggest that the drug can reduce the risk of RSV lower respiratory tract disease by over 80%. Additionally, the risk of severe illness was nearly 95% lower in vaccinated participants.

Although it was not the first to be approved, Pfizer’s RSV vaccine, Abrysvo, was approved by the FDA on May 31, 2023, just weeks after the GSK approval. Once again, the drug is for adults over 60 years old.

With two newly available prevention tools on the market, the CDC Advisory Committee on Immunization Practices (ACIP), endorsed by CDC Director Rochelle P. Walensky, MD, MPH, advises older patient and their physicians to consider the benefits of the RSV vaccine, recommending a single dose if perceived as beneficial for the individual patient.

“For the first time in US history, people 60 years and older can now receive a vaccine for protection against the RSV virus. With this CDC recommendation, the Administration is ensuring that Americans have access to stronger protection against circulating respiratory viruses. As we prepare for the fall vaccine campaign, we will follow the data and science to protect our nation's most vulnerable older adults, those living in nursing or long-term care facilities, and the immunocompromised,” noted HHS Secretary Xavier Becerra, in a recent HHS statement.