RSV Vaccination Averts Thousands of Severe Outcomes in First Year of US Adult Use
A new modeling study has found that respiratory syncytial virus (RSV) vaccination among US adults aged 60 years and older substantially reduced RSV-related emergency department (ED) visits, hospitalizations, and deaths during the first season of vaccine availability (2023 to 2024). The analysis used real-world uptake and effectiveness data for the adjuvanted RSVPreF3 (Arexvy) and non-adjuvanted RSVpreF (Abrysvo) vaccines.
According to the study, vaccination of nearly 20 million older adults prevented an estimated:
- 18 326 ED visits
- 23 630 hospitalizations
- 1930 deaths
These outcomes were modeled over one year using a multicohort Markov model, with real-world vaccine effectiveness data sourced from the CDC’s VISION network. Vaccine effectiveness against hospitalization was estimated at 83% for RSVPreF3 and 73% for RSVpreF.
“Findings indicate that RSV vaccination is providing a significant public health benefit in US adults aged ≥60 years, resulting in fewer RSV-related ED visits, hospitalizations, and deaths compared to no vaccination,” the authors stated.
Despite these benefits, overall RSV vaccine uptake remained significantly lower than influenza vaccine coverage. Real-world RSV vaccine uptake ranged from 17.5% to 30.6% depending on age group. In contrast, influenza vaccine uptake for similar populations ranged from 51.1% to 76.3%.
When the model assumed influenza-level uptake, projected benefits increased dramatically:
- 65 740 ED visits averted
- 84 551 hospitalizations averted
- 6838 deaths averted
This scenario represents nearly triple the health benefit of the observed RSV vaccination uptake.
The study also compared outcomes by vaccine type. Assuming 1 million adults vaccinated with each product:
- RSVPreF3 averted: 1248 hospitalizations and 102 deaths
- RSVpreF averted: 1097 hospitalizations and 90 deaths
Both vaccines showed strong performance, and while RSVPreF3 averted more hospitalizations and deaths, the study emphasized that all confidence intervals overlapped.
The authors emphasized the need to improve RSV vaccination uptake to realize the full potential public health impact, especially given CDC's updated 2024 guidance recommending RSV vaccination for all adults 75 years and older and for high-risk adults aged 60 to 74 years.
Although limited by a one-year time horizon and assumptions about vaccine waning, this study provides a compelling case for broader RSV vaccine implementation. Future analyses incorporating multi-season effectiveness data and head-to-head comparisons will help further refine policy recommendations.
References
Verelst F, Singer D, Graham J, Grace M, et al. Public health impact of RSV vaccination among adults aged 60 years and older in the United States using real-world evidence from the initial post-introduction season. Expert Rev Vaccines. 2025;24(1):797–806. doi:10.1080/14760584.2025.2539893
