Respiratory syncytial virus (RSV) vaccination recommendations in older adults

Respiratory syncytial virus (RSV), first linked to severe respiratory illnesses (bronchiolitis or pneumonia) in infants and children, is now recognized as a serious problem in older adults. Since the 1970s, RSV outbreaks have been observed in various long-term care facilities housing older adults. Various studies highlighted that RSV is a major driver of illness in older adult community-dwelling populations. Recently, in Canada, three vaccines, Arexvy, Abrysvo, and mResvia, have been authorized for use in older adults to prevent RSV-related lower respiratory tract disease. The National Advisory Committee on Immunization (NACI) strongly recommends immunization programs for certain older adult populations, particularly those at an increased risk of severe RSV disease. Health care providers, including nurse practitioners (NPs), should discuss RSV vaccination with older adult patients due to their increased likelihood of comorbidities and age-related changes, such as immunosenescence and inflamm-aging, that increase their risk for severe disease. Monitoring of RSV vaccine efficacy and safety is ongoing. The purpose of this article is to inform NPs about the recent development of these vaccines, summarizing the safety and efficacy information and presenting a decision tree to help NPs make vaccine recommendations for nonpregnant adults.