Awareness and Access Gaps Hinder Uptake of RSV Vaccine Among Older Adults
A cross-sectional study has found that despite the availability of the first respiratory syncytial virus (RSV) vaccines for US adults aged 60 years and older during the 2023-2024 season, only a small fraction of eligible individuals received the vaccine, largely due to limited awareness and access.
Conducted across 26 hospitals in 20 states, the study analyzed data from 6746 hospitalized adults with RSV-negative acute respiratory illness (ARI). Researchers sought to identify patient- and community-level factors associated with RSV vaccination, as well as attitudes and knowledge regarding RSV disease and immunization.
The findings, published in JAMA Network Open, reveal that only 10.4% of the cohort had received the RSV vaccine. Among the unvaccinated group, nearly half (47.2%) were unaware of RSV or uncertain if they had heard of it. Furthermore, 78.5% were unsure whether they were eligible for vaccination or believed they were not.
Certain demographic and clinical characteristics were significantly associated with higher vaccination rates. Individuals aged 75 years or older, men, and those with chronic pulmonary disease or immunocompromised conditions were more likely to be vaccinated. Socioeconomic factors also played a key role: Patients with higher levels of education and those residing in communities with low to moderate social vulnerability had higher vaccination uptake. Conversely, the likelihood of receiving the vaccine was lower among residents of long-term care facilities, uninsured individuals, and those with Medicaid coverage.
The 2023 Advisory Committee on Immunization Practices recommendations allowed RSV vaccination for adults 60 years and older based on shared clinical decision-making, a policy that may have contributed to confusion around eligibility. Updated guidance now recommends RSV vaccination for all adults 75 years and older and for those 60 to 74 years old at increased risk, aiming to streamline decisions and improve coverage.
The researchers emphasize the need for targeted education campaigns, expanded access to primary care, and proactive discussions between clinicians and patients to improve awareness and vaccine confidence.
Reference
Surie D, Yuengling KA, Safdar B, et al. Patient- and community-level characteristics associated with respiratory syncytial virus vaccination. JAMA Netw Open. 2025;8(4):e252841. doi:10.1001/jamanetworkopen.2025.2841
