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RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons.

JAMA2025-09-01PubMed
Total: 76.0Rigor: 7Innovation: 7Journal: 10Clinical: 8

Summary

In a 26-hospital, 2-season test-negative study of 6958 adults ≥60 years, one-dose RSV vaccination reduced RSV-associated hospitalization by 58% overall, with higher effectiveness for same-season vaccination (69%) vs prior-season (48%). Effectiveness was substantially lower in immunocompromised adults and those with cardiovascular disease.

Key Findings

  • Overall vaccine effectiveness against RSV-associated hospitalization was 58% across two seasons.
  • Effectiveness was 69% for same-season vaccination vs 48% for prior-season vaccination.
  • Effectiveness was lower in immunocompromised adults (30%) vs immunocompetent (67%) and in those with cardiovascular disease.

Clinical Implications

Supports RSV vaccination to prevent severe respiratory illness in older adults and suggests earlier revaccination or alternative strategies for immunocompromised patients.

Why It Matters

This study provides robust, multi-season effectiveness data that will inform booster interval decisions and risk-group prioritization.

Limitations

  • Observational design susceptible to residual confounding and healthy vaccinee bias
  • Vaccine product-specific and durability beyond two seasons not fully assessed

Future Directions

Define optimal revaccination intervals, evaluate effectiveness in frail subgroups, and assess outcomes beyond hospitalization (e.g., progression to ARDS).

Study Information

Study Type
Case-control
Research Domain
Prevention
Evidence Level
III - Well-conducted multicenter observational case-control (test-negative) study
Study Design
OTHER