RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons
Recommended Citation
Surie D, Self WH, Yuengling KA, Lauring AS, Zhu Y, Safdar B, Ginde AA, Simon SJ, Peltan ID, Brown SM, Gaglani M, Ghamande S, Columbus C, Mohr NM, Gibbs KW, Hager DN, Prekker M, Gong MN, Mohamed A, Johnson NJ, Steingrub JS, Khan A, Duggal A, Gordon AJ, Qadir N, Chang SY, Mallow C, Felzer JR, Kwon JH, Exline MC, Vaughn IA, Ramesh M, Papalambros L, Mosier JM, Harris ES, Baughman A, Cornelison SA, Blair PW, Johnson CA, Lewis NM, Ellington S, Grijalva CG, Talbot HK, Casey JD, Halasa N, Chappell JD, Rutkowski RE, Ma KC, and Dawood FS. RSV Vaccine Effectiveness Against Hospitalization Among US Adults Aged 60 Years or Older During 2 Seasons. JAMA 2025.
Document Type
Article
Publication Date
8-30-2025
Publication Title
JAMA
Abstract
IMPORTANCE: Respiratory syncytial virus (RSV) vaccines for adults aged 60 years or older became available in 2023. One dose is recommended for all adults aged 75 years or older and those aged 60 to 74 years at increased risk of severe RSV; however, duration of protection is unknown.
OBJECTIVE: To evaluate RSV vaccine effectiveness against RSV-associated hospitalization among adults aged 60 years or older during 2 RSV seasons.
DESIGN, SETTING, AND PARTICIPANTS: A total of 6958 adults aged 60 years or older were included in this test-negative, case-control study if they were hospitalized with acute respiratory illness at any of 26 hospitals in 20 US states during the October 1, 2023, to March 31, 2024, or October 1, 2024, to April 30, 2025, RSV seasons and had respiratory virus testing within 10 days of illness onset. Case patients tested positive for RSV only; control patients tested negative for RSV, SARS-CoV-2, and influenza. Demographic and clinical data were obtained through patient interview and electronic health records.
EXPOSURES: Receipt of 1 RSV vaccine dose at least 14 days before illness onset.
MAIN OUTCOMES AND MEASURES: Multivariable logistic regression was used to compare the odds of RSV vaccination among hospitalized cases and controls. Models were adjusted for age, sex, race and ethnicity, geographic region, and calendar month and year. Vaccine effectiveness was estimated as (1 - adjusted odds ratio) × 100%. Analyses were stratified by timing of RSV vaccine receipt (same vs prior season) relative to illness onset.
RESULTS: Of 6958 adults aged 60 years or older, 821 (11.8%) were RSV cases and 6137 (88.2%) were controls. A total of 1438 patients were Black (20.1%) and 4314 were White (62.0%); 3534 were female (50.8%). Median age was 72 years (IQR, 66-80 years) and 1829 adults (26.3%) were immunocompromised. A total of 63 cases (7.7%) and 966 controls (15.7%) were vaccinated. Estimated vaccine effectiveness against RSV-associated hospitalization was 58% (95% CI, 45%-68%) during 2 seasons and 69% (95% CI, 52%-81%) for same-season vaccination vs 48% (95% CI, 27%-63%; P = .06) for prior-season vaccination. Estimated vaccine effectiveness during 2 seasons was significantly lower among immunocompromised adults (30%; 95% CI, -9% to 55%) than immunocompetent adults (67%; 95% CI, 53%-77%; P = .02) and among those with cardiovascular disease (56%; 95% CI, 32%-72%) vs without (80%; 95% CI, 62%-90%; P = .03).
CONCLUSIONS AND RELEVANCE: Respiratory syncytial virus vaccines prevented RSV-associated hospitalization during 2 seasons, although effectiveness was lower in patients with immunocompromise and cardiovascular disease than in those without these conditions. Ongoing monitoring is needed to determine the optimal RSV revaccination interval.
PubMed ID
40884491
ePublication
ePub ahead of print
