Written by Babatunde Carew
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In a retrospective observational study utilizing a multisite electronic health record network, RSV vaccination with Abrysvo and Arexvy reduced RSV associated hospitalizations during the 2023–24 season among US adults aged ≥60 years regardless of immunocompromised status.
Synopsis
This study evaluated the effectiveness of respiratory syncytial virus (RSV) vaccines in preventing RSV-associated hospitalizations and emergency department (ED) visits among U.S. adults aged ≥60 during the 2023–24 RSV season. Using a test-negative design within a multisite electronic health record network, vaccine effectiveness (VE) was assessed. Among immunocompetent adults, VE against hospitalization was 80% (95%CI 71–85) and 81% (52–92) against critical illness (ICU admission and/or death). VE was 77% (70–83) for ED visits. Among immunocompromised individuals, VE against hospitalization was 73% (48–85). VE estimates were consistent across age groups, vaccine types, and time since vaccination, though slight reductions were observed after 60 days. Limitations included reliance on electronic records and a relatively short follow-up period. These findings, among the first to demonstrate real-world RSV vaccine effectiveness in the U.S., underscore the vaccines’ potential to reduce morbidity and mortality from severe RSV disease, especially in high-risk populations, supporting their use in adults aged ≥60. (AI-generated)
RSV vaccination decreased RSV hospitalizations in 2023
Among U.S. adults, RSV is estimated to cause 123,000–193,000 hospitalizations, 24,400–34,900 ICU admissions, and 4,680–8,620 deaths annually. In 2023, two recombinant RSV vaccine formulations (Abrysvo and Arexvy) were approved for adults ≥ 60 and from age 18 to 59 who are at increased risk. A third, mRNA based formulation (mResvia) was approved in 2024. This study evaluated the efficacy of Abrysvo and Arexvy against severe RSV among adults ≥ 60 using a test negative design, comparing odds of vaccination in a case group (RSV positive) and a control group (RSV negative) among patients with symptoms of a viral infection who were hospitalized, critically ill, or seen in the ED. Overall, the findings demonstrated that RSV vaccination was extremely effective against RSV-associated hospitalization and ED encounters in immunocompetent adults ≥ 60 and against ED encounters in immunocompromised adults ≥ 60, further supporting the practice of vaccinating this at-risk population. Further studies are needed to determine the duration of immunity, real-world effectiveness of RSV vaccination in high risk adults aged 18 to 59, and effectiveness of the mRNA based formula.
Source
Respiratory syncytial virus (RSV) vaccine effectiveness against RSV-associated hospitalisations and emergency department encounters among adults aged 60 years and older in the USA, October, 2023, to March, 2024: a test-negative design analysis. Lancet. 2024 Oct 19;404(10462):1547-1559. doi: 10.1016/S0140-6736(24)01738-0. PMID: 39426837
