This year, the Food and Drug Administration approved the first two vaccines that can protect older adults from respiratory syncytial virus, which leads to at least 6,000 deaths and 60,000 hospitalizations among adults 65 and older each year.
This winter marks the first opportunity to see how the R.S.V. vaccines work for older adults in the real world — provided those at highest risk go get vaccinated.
But while cases have been climbing across the country over the past few months, only 14.8 percent of adults 60 and over have been vaccinated against the virus, the Centers for Disease Control and Prevention said this month.
The C.D.C., citing a need for more data on potential safety concerns that arose in clinical trials, has not issued a blanket recommendation for every person 60 and older to get the shot this year. Instead, health officials have said vaccination should be targeted toward people at highest risk of severe illness, which includes people with underlying medical conditions and those 75 and over, among others.
Even still, experts said they hoped vaccination rates would be much higher by now, and pointed to a host of obstacles with the new shots. After the prolonged push for Covid shots, people may feel “vaccine fatigue,” said Dr. Kathleen Linder, an infectious disease specialist at Michigan Medicine. The pandemic also fueled vaccine hesitancy, she added. Beyond that, experts noted, some people with private insurance have been billed over $300 to get the R.S.V. vaccine, which could dissuade others from seeking the shot.
“We haven’t organized ourselves optimally,” said Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine. “This first year is a training year. We’re going to have to figure out how to do this better going into the future.”
Many older adults may also not be aware of how severe a threat R.S.V. poses to them, said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco. “People have this idea that R.S.V. is a kid disease,” he said. While the virus usually causes cold-like symptoms for most people, it can lead to serious lung issues like pneumonia and even death in older adults, babies and people who are immunocompromised.
What to discuss with your doctor
In clinical trials, the vaccines — one developed by Pfizer, and another by GSK — reduced the risk of lower respiratory tract diseases such as pneumonia due to R.S.V. in the first virus season after vaccination. Vaccination may be particularly critical for people with conditions like chronic heart or lung disease or weakened immune systems.
“If you’re at high risk, it’s kind of a no-brainer,” Dr. Chin-Hong said.
The older you are, the greater your risk of severe R.S.V. tends to be. The virus is especially dangerous for people 75 and older, said Dr. Camille N. Kotton, an infectious disease physician at Massachusetts General Hospital and member of the C.D.C. Advisory Committee on Immunization Practices. Living in an environment like a nursing home can also put you at greater risk.
It’s not clear, however, that every healthy 60-year-old without underlying medical conditions would “truly benefit” from the vaccine, Dr. Kotton said.
If you are 60 or older, experts advise talking to your doctor or a pharmacist about your risk and whether the shot is right for you.
People who get vaccinated can experience fatigue, fever and pain at the injection site. Clinical trials of the vaccines also showed a “very small but somewhat concerning” safety signal, Dr. Kotton said.
Out of the roughly 38,000 older adults who received either vaccine in clinical trials, 20 experienced atrial fibrillation and six were reported to have developed neurological complications, including brain inflammation and a rare autoimmune condition called Guillain-Barré syndrome, in the weeks after vaccination.
“At this time, there is not enough information to determine whether these findings were simply due to chance, or if they represent an increased risk of neurologic adverse events,” Dr. Michael Melgar, a medical officer with the C.D.C.’s Coronavirus and Other Respiratory Viruses Division, wrote in an email.
So far, though, the safety data from the more than five million doses administered to people 60 and over has been reassuring, said Dr. Sarah S. Long, a professor of pediatric infectious diseases at Drexel University College of Medicine and a member of the C.D.C. Advisory Committee on Immunization Practices. “We’re continuing to look, and I think it will get clarified,” she said.
If you’re interested in the R.S.V. vaccine, you may want to get the shot sooner rather than later, especially as the holidays loom, said Dr. Seth Cohen, medical director of infection prevention at the University of Washington Medical Center.
You also might want added protection if you are 60 or older and will be interacting with young children, who may be likelier to have the virus and are also at risk of severe complications.
“Having this vaccine is a big win in our fight against keeping people out of the hospital, and keeping older folks protected during respiratory virus season,” Dr. Cohen said.
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