Real-world data shows it’s worth the effort, according to Scottish researchers.
The RSV vaccine reduced hospital admissions by 62% for people aged 74-79 over last year’s Scottish winter, according to early results.
Scotland’s vaccination program, launched in August 2024, used one of the two vaccines available and recommended for this age group in Australia, the unadjuvanted bivalent vaccine Abrysvo.
By September 2024, in time for the start of the Scottish winter, 52% of people aged 74 (turning 75) to 79 were vaccinated, with that number rising to 70% by the end of November.
“Given this high and early uptake in Scotland, we hypothesised a considerable reduction in RSV-related hospital admissions among the eligible older population in 2024,” the authors from Public Health Glasgow wrote in The Lancet Infectious Diseases.
So far, they have not been disappointed.
“Circulation of influenza, covid-19, and other seasonal respiratory illnesses remained low throughout November, 2024, with nearly two-thirds (62%) of hospital admissions due to RSV compared with around one-fifth in influenza (20%) and covid-19 (18%),” the authors wrote.* “Influenza cases and hospitalisations eventually started to increase alongside persistently high RSV rates.”
Without vaccination, hospitalisation rates for this age group were projected to increase by 6% for every additional year of age, reflecting the increased vulnerability to more severe disease with each year of ageing.
A series of data points from 2023 shows hospitalisation rates climbing with every increased year of age from 70 to 84. But in 2024, when the vaccine program was in full swing, there is a giant dip, reflecting a marked drop in hospitalisation rates for the vaccinated group (75-79).
“[F]ollowing introduction of the vaccine, a 62·1% reduction in RSV-related hospitalisations among the eligible age group was observed,” the authors wrote.
Winter is barely over in Scotland, so the data is not all in yet and the finer details have not been published. The researchers will do the usual end-of-year vaccine effectiveness analysis, with a full data set.
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“However, these limitations do not detract from the key study finding of a near two-thirds reduction in RSV hospitalisations among the eligible population,” the authors wrote.
“This study is one of the first real-world investigations within the UK and Europe into vaccine impact in older people, during a period of high RSV circulation … Our findings provide strong evidence that the RSV vaccine reduces hospitalisations in older people, offering a basis to inform vaccination policy, promote vaccine uptake, and strengthen RSV vaccination programmes, ultimately reducing the disease burden and associated economic costs.”
The Australian Immunisation Handbook recommends RSV vaccination with Abrysvo for pregnant women, and with Arexvy or Abrysvo for everyone aged 75 and older, Aboriginal and Torres Strait Islander people aged 60 and older, and people medically at risk of severe disease who are aged 60 and older.
Lancet Infectious Diseases, 13 February 2025
*This story has been edited since publication to substitute a quote about the proportion of hospitalisations due to RSV, rather than a paraphrased version. As noted in the comments below, this proportion seems high, and it is unclear in the paper whether it represents a proportion of a subgroup.
