Effectiveness and Safety of Respiratory Syncytial Virus Vaccine for US Adults Aged 60 Years or Older

VE for the RSV protein subunit vaccine in this case-control study was similar to the VE in clinical trials. The VE for immunocompromised patients was mildly (overall) to moderately (for stem cell transplant recipients) diminished. Risk of immune thrombocytopenic purpura after vaccination was not elevated, but the risk of Guilain-Barré syndrome was statistically significantly elevated in patients who received the RSVPreF vaccine but not in those who received RSVPreF+AS01 vaccine, although the risk was small. These observations should inform clinicians' choices and patient instructions.