ACP InternistCDC Publishes Recommendations on Use of RSV Vaccines

The FDA approved two RSV vaccines for adults 60 and older in May: one by GSK and the other by Pfizer.

The Advisory Committee on Immunization Practices (ACIP) has issued recommendations on the administration of the recently approved RSV vaccines for adults aged 60 and above, with the guidelines becoming official CDC policy.

Key Points:

• ACIP recommends a single dose of RSV vaccine for this age group, emphasizing shared clinical decision-making.
• Clinical trials data indicates moderate to high efficacy of the vaccines in preventing symptomatic RSV-associated lower respiratory tract disease over two RSV seasons.
• Trials were underpowered to determine efficacy against RSV-associated hospitalization and death, but evidence suggests potential reduction in morbidity from RSV disease.

Additional Points:

• Six cases of inflammatory neurologic events, including Guillain-Barré syndrome, were reported post-vaccination, but vaccines were generally well-tolerated.
• Vaccination should ideally occur before the RSV season, though COVID-19 has disrupted typical RSV seasonality.
• For the 2023-24 season, RSV vaccination should be offered to eligible adults as soon as supply is available.
• Coadministration with other adult vaccines is acceptable but may increase risk for reactions.
• RSV vaccines should be delayed for those with moderate or severe acute illness and are contraindicated for those with a history of severe allergic reactions to vaccine components.

Conclusion:

• The new RSV vaccine recommendations provide a structured approach for clinicians to vaccinate older adults, emphasizing individual risk assessment and patient preferences.

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Did You Know?
According to the CDC, in older adults, especially those 65 and older, RSV can lead to serious complications, with an estimated 177,000 hospitalizations and 14,000 deaths annually in the US due to the virus.