Despite the FDA approval of three RSV vaccines—GSK's Arexvy, Pfizer's Abrysvo, and Moderna's mResvia—for adults aged 60 and older, uptake remains low, with less than 25% of eligible individuals vaccinated as of spring 2024. This concerning trend highlights the challenges in public health awareness and vaccine confidence, even as the risk of RSV infection in older adults remains significant.
Low Vaccination Rates and Hesitancy
A recent survey by the National Foundation for Infectious Diseases (NFID) revealed that only 38% of eligible recipients plan to get an RSV vaccine during the 2024-25 respiratory virus season. The reasons cited for not getting vaccinated include concerns about side effects (45%), distrust of vaccines in general (38%), and lack of recommendation from a doctor (24%). Dr. Robert Hopkins Jr., NFID medical director, noted a general decline in confidence in vaccines and healthcare, contributing to this hesitancy.
The Risk of RSV in Older Adults
RSV, like COVID and the flu, is a respiratory virus that can cause severe illness, especially in older adults. Symptoms include congestion, coughing, fever, and difficulty breathing. According to the CDC, older adults with RSV can develop pneumonia, and those with complications like asthma, heart failure, and COPD may experience worsening conditions. Annually, approximately 6,000 to 10,000 people aged 65 and older die from RSV in the U.S.
Recommendations and Eligibility
The CDC recommends that everyone ages 75 and older receive the RSV vaccine, as well as those ages 60 to 74 who are at increased risk of severe RSV due to chronic medical conditions or living in nursing homes. While there is no formal recommendation for the general population younger than 60, the FDA approved Arexvy for adults aged 50 to 59 who are at increased risk of RSV lower respiratory tract disease. Expectant parents can also provide passive immunity to their unborn children by getting the Abrysvo shot late in pregnancy, and infants may be eligible for nirsevimab, a monoclonal antibody treatment.
Available RSV Vaccines
- Moderna mResvia: Indicated for adults 60+, with one dose needed, recommended late summer through early fall.
- Pfizer Abrysvo: Indicated for adults 60+ and people 32–36 weeks pregnant, with one dose needed, recommended late summer through January for pregnant individuals.
- GSK Arexvy: Indicated for adults 60+ and adults 50–59 at high risk of RSV-caused lower respiratory tract disease, with one dose needed, recommended late summer through early fall.
Unlike the flu and COVID vaccines, which are reformulated annually due to rapid viral mutations, RSV evolves more slowly. This means a single dose of the RSV vaccine is currently sufficient to provide protection against severe infection. As more data becomes available, experts hope to expand the use of these vaccines to provide protection for a broader segment of the population.
