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Researchers Assess Burden of RSV Hospitalization Prior to Vaccine Introduction
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Key Takeaways
- RSV causes significant morbidity and mortality in older adults, with high hospitalization and death rates annually in the US.
- The study used RSV-NET data to assess RSV burden, revealing high hospitalization rates, especially among those aged 75 and older.
Increasing vaccine coverage among adults at highest risk could lessen associated hospitalizations and severe outcomes caused by RSV.
Respiratory syncytial virus (RSV) infection is known to cause severe illness in adults aged 60 years and older. However, the burden of RSV-associated hospitalizations among this population prior to the approval of RSV vaccines is unknown. Researchers conducted a cross-sectional study that assessed confirmed RSV cases from 2016-2017 through 2022-2023, to evaluate RSV burden.1
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The CDC provided data showing that the US experiences up to 160,000 hospitalizations and around 10,000 deaths among older adults due to RSV infection each year. Symptoms typically present like a mild cold but could become more severe among older adults.2
In 2023, the FDA approved 3 RSV vaccines—RSVPreF3 (Arexvy; GSK), RSVpreF (Abrysvo; Pfizer,) and mRNA-1345 (mRESVIA; Moderna). Following the approvals, in June of 2023, the CDC recommended that individuals 60 years and older receive a single dose of RSV vaccine using shared clinical decision making.3 However, in June 2024, a year after the initial release of recommendations, the Advisory Committee on Immunization Practices (ACIP) issued updated recommendations for a single dose of any FDA-approved RSV vaccine for adults 75 years and older and for adults 60 to 75 years who are at increased risk for severe RSV. The updated recommendations replaced the previous suggestions which emphasized shared clinical decision-making.4
Despite the proven success of RSV vaccination, limited data are available about the impacts of RSV-associated hospitalization, prior to the release of the approved RSV vaccines.
“To assess vaccine impact, it is essential to clearly define the pre-vaccine burden of RSV disease in this population,” said the study authors, in the press release.1
Researchers conducted a cross-sectional study that used data from the RSV Hospitalization Surveillance Network (RSV-NET), which is a population-based surveillance platform that provides data of RSV-associated hospitalizations in 8% of the US population. The study included data from 2016-2017 through 2022-2023, among 16,575 individuals with a laboratory confirmed RSV-associated hospitalization. Among the total group of individuals, 62.6% were 65 years or older and 39.7% were 75 years or older.1
Initial data found that hospitalization rates peaked each January during 2016-2017 through 2019-2020, before displaying a reduced and atypical circulation in 2020-2021 and 2021-2022 due to COVID-19 prevention strategies. However, increased circulation and an earlier peak was reported from 2020 to 2023, according to study authors.1
Among the 16,575 individuals, the results showed an estimated RSV-associated hospitalizations rate of 48.9 to 76.2 per 100,000 adults per season. The rates confirm a high burden of RSV prior to the approval of vaccines, with an estimated 123,000 to 193,000 hospitalizations, 24,400 to 34,900 ICU admissions, and 4680 to 8620 in-hospital deaths occurring annually among US adults. Further results displayed that among the in-hospital deaths, most occurred among the 75 years or older population, who face the highest burden.1
“These findings validated RSV as a substantial contributor to respiratory illness and hospitalization among adults, especially older adults, with up to 136 000 estimated annual hospitalizations among those 65 years or older,” said the study authors, in the press release.1
The findings suggest that increasing vaccine coverage among adults at highest risk could lessen associated hospitalizations and severe outcomes caused from RSV.1
