ASHP Midyear: Vaccination Among Older Adults Prevents Severe RSV Infections

Chelsea Keedy, PharmD, BCACP, clinical assistant professor at the University of Georgia, discusses the significant health and economic impact of respiratory syncytial virus (RSV) infections, particularly on older adult populations. RSV poses the greatest risk to adults 60 and over, resulting in 6,000 to 10,000 deaths and 60,000 to 150,000 hospitalizations annually in the US. The economic burden on the health care system is over $6 billion per year, with 94% of those costs stemming from the 4% of individuals who require hospitalization. Vaccination is now recognized as a crucial prevention strategy, as the RSV vaccine has only recently become available. The CDC's vaccination guidelines recommend the vaccine for all adults 75 and older, as well as high-risk individuals aged 60 to 74 with conditions like chronic lung disease, chronic kidney disease, diabetes, obesity, and those living in long-term care facilities.

Pharmacy Times: What is the burden of RSV for older adults, including complications and hospitalizations?

Chelsea Keedy: The [respiratory syncytial virus (RSV)] poses the greatest risk to our most vulnerable populations. So really, our older adults and our younger adults, and in our older adults 60 years and over, there's about 6 to 10,000 deaths a year and about 60,000 to 150,000 hospitalizations a year because of RSV.

Pharmacy Times: What is the economic impact of RSV infections, specifically for older adults, on both the individual and the health care system?

Keedy: So the economic burden of the RSV infection on older adults really varies. Overall, it's estimated in the United States that the economic burden to the health care system is over $6 billion a year, but when you really look at it, about 94% of those costs are in the 4% of individuals that are hospitalized because of the RSV infection. So that's why prevention of RSV is so important to avoid that high cost burden and our most vulnerable populations in our older adults and those especially that are older and have comorbidities. It can really vary in terms of the economic burden for the individual.You're looking at maybe up to a few $100 out of pocket for a vaccine to an [intensive care unit] stay could cost up to $20,000, right? The average hospitalization for a RSV-associated admission is probably somewhere between $8,000 and $10,000 so I think again, that really gives credibility to why vaccination and prevention is so important to avoid that high-cost area that's possible with infection associated with the virus.

Pharmacy Times: What are the current strategies to prevent RSV in older adults?

Keedy: So really, the current strategies around prevention of RSV in older adults as vaccination, and this is a huge revelation, because RSV is not new, but the vaccine is. So we've only had the vaccine for a few years, and we just talked about what that high economic burden is. So now we finally have something available to us to truly prevent the infection in older adults through vaccination.

Pharmacy Times: Are there any recommendations specific for older adults at high risk for RSV?

Keedy: So the vaccination guidelines set forth by the CDC really focus on older adults. So all older adults, 75 and older, should get the vaccine. And that's a blanket statement. So that's different in 2024 than it was in 2023 and then for individuals aged 60 to 74 those at high risk for RSV are advised to get the vaccination. So those are individuals with chronic lung disease, chronic kidney disease, diabetes, especially with end-stage organ damage, those living in long-term facilities, those with morbid obesity. So these are the individuals, not only age based, but additional comorbidities, in which we really are encouraging these individuals to get vaccinated against RSV.