CDC Advisory Panel Recommends RSV Vaccines for Older Adults

Yesterday, the US Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) voted to recommend older adults receive a respiratory syncytial virus (RSV) vaccine this fall.

After 13 voting members indicated adults 60-64 years of age may receive an RSV vaccine “using shared clinical decision-making,” ACIP voted 9-5 in favor of recommending the GSK and Pfizer RSV vaccines for adults aged 65 years and older.

ACIP advises the CDC, so the recommendation still has to be made official by CDC director Rochelle P. Walensky, MD, MPH. Because Walensky will be stepping down at the end of June, this could be one of her last major approvals as head of the CDC.

Despite the disease being first identified in the 1950s, the world had no available vaccine for RSV until this year. First, the US Food and Drug Administration (FDA) approved GSK’s Arexvy (RSVPreF3 +AS01E)to prevent lower respiratory tract disease (LRTD) caused by RSV in adults 60 years and older. Within the month, the FDA approved Pfizer’s Abrysvo (bivalent RSV prefusion F; RSVpreF) for the same patient population. Both decisions came after recommendations from the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC).

RSV a common respiratory virus that typically causes mild, cold-like symptoms. While most people recover within 2 weeks, infants and older adults are susceptible to severe and even fatal infection. Because RSV primarily affects the lungs and breathing passages, disease severity can increase with age and comorbidities such as chronic obstructive pulmonary disease, asthma, and congestive heart failure.

The need for the world’s first RSV vaccine became more dire than ever this past year, as this past season came early and intensely. The CDC reported overall hospitalizations last season peaked at 19.5 per 100000 people. For reference, the previous high was a peak of 8.8 overall hospitalizations per 100000 people, recorded during the 2019-2020 RSV season.

Infants and young children are also susceptible to the worst of RSV infection. Thus, Pfizer is also seeking approval to administer RSVpreF to pregnant persons, with the goal of preventing medically attended lower respiratory tract disease (MA-LRTD) and severe MA-LRTD caused by RSV in infants from birth to 6 months of age.

The maternal vaccine was recently recommended for approval by the FDA’s VRBPAC, and a decision is expected by August 21, 2023.

Catch up with Contagion's RSV coverage here.