Boosting RSV Vaccination in Older Adults Could Save Thousands

Modest increases in vaccination coverage could yield significant public health benefits, preventing thousands of respiratory syncytial virus (RSV)–related hospitalizations and deaths over the next 5 years, a study shows.

RSV is a common respiratory virus that can cause severe illness, particularly in older adults and those with underlying health conditions.² In the US, RSV is a major cause of lower respiratory tract disease (LTRD), leading to hospitalizations, intensive care admissions, and even death during the fall and winter months. Symptoms can include cough, shortness of breath, wheezing, and fever, and the infection can be especially dangerous for adults 60 years and older. Vaccination has emerged as a key strategy to reduce the burden of RSV, prevent severe disease, and protect vulnerable populations from complications associated with infection.

The researchers used a multicohort Markov model to estimate the potential public health impact of RSV vaccination among US adults 60 years and older.¹ The model compared RSV-related outcomes, including LRTD cases, hospitalizations, and deaths, with and without adjuvanted RSVPreF3 vaccination.

Vaccination uptake rates were based on real-world claims data through February 2025, ranging from 8.1% among adults aged 60 to 64 to 23.3% among those aged 75 to 79. Assuming vaccination occurred in August 2023, the model incorporated clinical trial efficacy data and findings from targeted literature and public data sources. Disease burden reduction was projected over a 5-year period, from August 2023 to July 2028, under 3 scenarios: observed uptake, equal uptake of 23.3% across all age groups, and a uniform 5-percentage-point increase in uptake.

The model estimated that by February 2025, approximately 13.4 million US adults aged 60 years and older had received an RSV vaccine. Assuming vaccination began in August 2023, this uptake was projected to prevent about 714,362 cases of RSV-related LRTD, 74,082 hospitalizations, and 6025 deaths over a 5-year period compared with no vaccination. If all age groups achieved the highest observed uptake of 23.3%, an additional 5.8 million adults would have been vaccinated—preventing roughly 319,771 more RSV-LRTD cases, 21,411 hospitalizations, and 1589 deaths. A more modest 5–percentage point increase in uptake across all age groups would avert an additional 222,145 RSV-LRTD cases, 20,513 hospitalizations, and 1636 deaths, highlighting the substantial public health gains achievable through improved vaccination coverage.

On June 26, 2024, the CDC’s Advisory Committee on Immunization Practices (ACIP) updated its recommendations for RSV vaccination, advising that all adults 75 years and older—and adults aged 60 to 74 years at increased risk for severe RSV disease—receive a single dose of an approved RSV vaccine (Arexvy [GSK], Abrysvo [Pfizer], or mResvia [Moderna]).³ This update expands upon ACIP’s 2023 guidance, which left vaccination as an option for adults 60 years and older. The new recommendations, informed by recent clinical trial data and postlicensure evidence, aim to improve protection among those most vulnerable to severe RSV illness while ongoing monitoring continues to guide future policy decisions.

Overall, the findings from the RSV vaccination modeling study underscore the substantial public health benefits of increasing vaccine coverage among US adults 60 years and older. Even modest improvements in uptake could prevent hundreds of thousands of RSV-related LRTD cases. Achieving higher vaccination rates, particularly among age groups with lower coverage, has the potential to further reduce the burden of RSV and improve outcomes for older adults. These results highlight the importance of targeted public health strategies to maximize RSV vaccine uptake and protect the population most at risk.

References

1. La E, Graham J, Grace M, et al. Public health impact of increasing RSV vaccination uptake among US adults aged ≥60 years: a modeling analysis based on real-world uptake data through February 2025. Poster presented at: Academy of Managed Care Pharmacy Nexus 2025; October 27-30, 2025; National Harbor, MD.

2. Respiratory syncytial virus (RSV). Mayo Clinic. October 4, 2023. Accessed October 29, 2025. https://www.mayoclinic.org/diseases-conditions/respiratory-syncytial-virus/symptoms-causes/syc-20353098

3. Steinzor P. Updated ACIP guidelines: RSV vaccine for adults aged 60 years and older. AJMC^®. August 7, 2024. Accessed October 29, 2025. https://www.ajmc.com/view/updated-acip-guidelines-rsv-vaccine-for-adults-aged-60-years-and-older