Why Aren’t More Older Adults Getting the RSV Vaccine?

The first vaccines to prevent RSV in older adults were approved in 2023. But so far, only a small percentage of adults are taking advantage of it.

“Everybody knows about flu and the flu vaccine has been around for a long time,” says Amy Edwards, MD, a pediatric infectious disease specialist at University Hospitals Rainbow Babies & Children’s. “RSV tends to be just as serious an illness as flu for older adults, yet not many people are aware of it.”

A recent study found that if older people received the RSV vaccine at the same rate as the flu vaccine, it would cut hospitalizations and deaths by as much as 60 percent the first year. Early data shows that only about 17 percent of people 60 and older have gotten the vaccine this respiratory season. By comparison, about 70 percent of people 65 and older have gotten a flu shot.

What Is RSV?

RSV is a highly transmissible virus that causes infections of the lungs and respiratory tract. RSV season begins in fall, peaks during the winter and ends in the spring. Historically, it’s been known as a virus that primarily affects young children. Improved testing, however, has shown that RSV also causes significant numbers of hospitalizations and deaths in people over age 60.

“RSV is something we’ve dealt with in pediatrics since time immemorial, but in the adult world it wasn’t tested for a long time,” she says. “Older people would come in very sick with respiratory illness, but if they tested negative for the flu the illness was just labeled a viral infection.”

Adults most vulnerable for serious disease are older with weakened immune systems or chronic heart and lung diseases. “People think it’s a pediatric problem, but people over 60 can end up in the hospital. They can end up in the ICU and they can die from RSV,” Dr. Edwards says.

RSV causes an estimated 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths per year among U.S. adults 65 and older, according to the Centers for Disease Control and Prevention.

New Vaccines Offer Powerful Protection

The FDA has approved two RSV vaccines, Arexvy and Abrysvo. In clinical trials, Arexvy and Abrysvo were highly effective at preventing severe illness in older adults. Abrysvo was also approved for pregnant women. Research shows the vaccines provide protection for two respiratory seasons, with diminished protection the second year.

Dr. Edwards says aside from lack of awareness about RSV and the vaccine, more people have become reluctant to vaccinate themselves and their children because of mistrust fueled by politicization of the COVID-19 vaccines.

“It still hasn’t translated out in the community. A lot of people just don’t know what RSV is and they don’t know the impact it’s having on older adults,” Dr. Edwards says.

“If everybody got all three of their shots (for RSV, flu, and COVID-19), we’d empty out our hospitals. We have the tools to fundamentally change respiratory viruses in America. We have to do better and protect more people.”

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