How Disease Risk for RSV in Seniors May be Considered Towards Vaccine Application


A clinician discusses the vaccines' efficacy, which risk factors may rank higher for disease severity, and offers insights on counseling patients.

RSV may not get as much attention for seniors as other conditions associated with older adults; however, one clinician believes the virus should.

“We've done a number of studies, both here in the United States and around the world, that's really demonstrated that there's this bimodal incidence of severe disease and incidence of disease in general, that attacks the very young and the very old,” said Angela Branche, MD, associate professor of medicine, University of Rochester. “When we're talking about adults in their 60s, 70s, and 80s, the incidence actually doubles with every decade of life. By the time you're in your 80s, the incidence of RSV associated hospitalizations, is about 600 to 700 per 100,000 persons, so that's quite high. It can be as high as influenza, many seasons. It's higher than other infectious causes of pneumonia, and acute respiratory illnesses.”

Branche’s research involves population-based studies of RSV infection and the development of vaccine and antiviral agents for the respiratory virus.

Earlier this year, the FDA approved 2 vaccines for seniors including the GSK vaccine, RSVPreF3 +AS01E (Arexvy), and the Pfizer vaccine, RSV prefusion F (Abrysvo).

To learn more about the vaccines including data and an overview of them, go here.

“They were safe and very well tolerated with very minor symptoms when people were vaccinated,” said Branche. “And, it's a conversation you should be having with your doctor.”

Obviously, the hope is that there will be a reduction in incidence rates for severe RSV in this population because of these vaccines being available. Branche believes they will be beneficial to seniors, and right now it is about vaccine uptake and raising awareness about them. Branche also points out that there is great variability in seniors’ risk factors just like younger patients; therefore, all seniors should not be considered equal for risk for severe RSV.

“If you're in your mid to late 70s, or if you're in your 80s, and you live in a long-term care facility or assisted living facility, I have very little reservation in strongly recommending the RSV vaccines for those folks,” Branche said. “If you're in your 60s, it's still worth having a conversation with your provider about that, because not all 60 year olds are created equal. There are very healthy, very active 60 year olds who have no underlying medical conditions, and then there are those who are on dialysis with heart failure and with coronary disease and have had heart attacks in the past. And those are the ones for whom we know when you get an RSV infection, it can lead to a serious outcome. And so even if you're only 60 years old, I would still recommend an RSV vaccine for those kinds of patients.”

At the recent IDWeek, Branche participated in a number of sessions around RSV, and Contagion spoke to her at the conference. 

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