A committee of independent vaccine experts voted Wednesday to recommend expanding respiratory syncytial virus (RSV) vaccination to adults aged 50-59 who are at high risk of severe illness, potentially opening access to these protective measures for millions of Americans with underlying health conditions.
The Advisory Committee on Immunization Practices (ACIP) recommended that any RSV vaccine licensed by the Food and Drug Administration for high-risk adults ages 50 to 59 be made available to this demographic. If approved by the Centers for Disease Control and Prevention (CDC), insurance companies would be required to cover vaccination costs for eligible individuals.
Who Would Benefit from Expanded RSV Vaccination
According to CDC vaccines researcher Michael Melgar, approximately 30% of U.S. adults aged 50-59 would qualify for RSV vaccination under the new recommendation. This includes individuals with:
- Lung transplantation history
- Heart failure
- Chronic obstructive pulmonary disease (COPD)
- Chronic kidney disease
- Severe obesity
A cost analysis conducted by the CDC and University of Michigan researchers suggested that vaccinating these high-risk individuals could be cost-saving to the healthcare system.
Currently, CDC recommendations for RSV vaccination in older adults include all individuals 75 and older, plus those 60-74 who are at elevated risk of severe RSV illness. The committee has approached broader recommendations cautiously due to safety concerns and questions about long-term protection.
Safety Considerations for RSV Vaccines
Two of the currently available RSV vaccines—manufactured by Pfizer and GSK—have shown an elevated risk of Guillain-Barré syndrome, a rare neurological disorder. No such reports have emerged with Moderna's RSV vaccine, which is currently seeking FDA approval to extend its license to include high-risk adults aged 50-59.
Another consideration is the duration of protection. Current data suggest that while additional doses increase antibody levels, they do not return to the levels seen after initial vaccination. At present, RSV vaccines are recommended as a one-time shot, though experts anticipate future recommendations for booster doses.
New Vaccines for Meningitis and Chikungunya
The committee also voted to recommend several other vaccines:
GSK's Pentavalent Meningococcal Vaccine
The panel endorsed GSK's new five-in-one meningococcal vaccine (MenABCWY) for:
- People ages 16 to 23 for whom meningitis B protection is recommended
- Individuals ages 10 and older at increased risk of meningococcal disease due to underlying medical conditions
This vaccine protects against five types of meningococcal bacteria, including strains associated with college campus outbreaks.
Chikungunya Vaccines
The committee recommended Bavarian Nordic's chikungunya vaccine, Vimkunya, for:
- Travelers aged 12 and older visiting countries experiencing active outbreaks
- Laboratory scientists working with the chikungunya virus
- Individuals planning extended stays (six months or longer) in areas with elevated transmission risk
Chikungunya infection, transmitted by infected mosquitoes, causes fever and potentially severe and long-lasting muscle and joint pain. The disease has been recorded in approximately 120 countries globally, though outbreaks are unpredictable.
The committee also modified its previous recommendation for Valneva's chikungunya vaccine. Following reports of six serious side effects in older adults after vaccination—five requiring hospitalization—the panel added a precaution about using this vaccine in people 65 and older, though it did not recommend against its use in this age group.
Implementation Challenges
The implementation timeline for these recommendations remains unclear due to leadership transitions at the CDC. The agency currently lacks a permanent director, as nominee Susan Monarez awaits Senate confirmation.
CDC chief of staff Matthew Buzzelli will receive the committee's six recommendations from Wednesday's meeting. Some legal experts suggest that in the absence of a confirmed CDC director, Health Secretary Robert F. Kennedy Jr. could potentially sign off on the committee's recommendations.
These recommendations, if approved, would significantly expand vaccine access for vulnerable populations and travelers, potentially reducing the burden of these infectious diseases across different age groups and risk categories.
