Could more adults than just those aged 75–79 years potentially benefit from vaccination against RSV: insights from UK data

In his recent editorial Dr. Hameed Merchant questions why UK adults aged ≥ 80 years of age are not included in the recently introduced national adult RSV immunisation programme. He provides insights suggesting that this age group is at highest risk of hospitalisation following an RSV infection and highlights that efficacy data in those aged ≥80 years from the pivotal clinical trials lacked sufficient precision to support vaccine use in this most elderly age group. He also mentions a need to consider the vaccine for adults aged <75 years in clinical risk groups. We discuss these issues further and summarise those relevant UK data currently available illustrating the annual healthcare burden across the national health service (NHS) attributed to adult RSV infection stratifying by general practitioner (GP) consultations, hospitalisations and accident and emergency (A&E) attendances. These suggest that >630,000 UK adults use NHS services annually due to RSV and shows that a high proportion of adult RSV attributed hospitalisations (∼55%) and A&E attendances (∼48%) occur in those aged ≥75 years. Further UK data now reinforce that the risk of RSV associated hospitalisation increases substantially with increasing age in the most elderly with real-world evidence also now starting to emerge showing the vaccine to be effective in this age group. However, ∼77% of the total annual adult RSV attributed healthcare burden occurs in UK adults aged 18-74 years with ∼14 million adults in this age group estimated to have at least one underlying risk condition for more severe outcomes following a respiratory infection. This supports the need to also consider RSV vaccination for those aged 18-74 years though further research is currently required to optimally identify underlying risk conditions that may specifically be associated with more severe outcomes following an RSV infection. <b>Trial registration:</b> ClinicalTrials.gov identifier: NCT05921903.