CDC Strengthens RSV Vaccine Recommendation Only for Older Adults

U.S. health officials on Wednesday strengthened their support for RSV vaccination for people 75 and older, but offered a narrower recommendation for people 60 to 74.

The director of the Centers for Disease Control and Prevention has accepted the recommendations of a panel of outside advisers, making this the government’s updated guidance for doctors.

A year ago, the same advisory group said people 60 and older should just talk to their doctor about whether to get vaccinated. Doctors said this type of lukewarm recommendation is confusing for patients, difficult to explain and likely a reason why fewer than 25% of older Americans have gotten vaccinated.

An electron microscope image shows human respiratory syncytial virus (RSV) virions, colored blue, and anti-RSV F protein/gold antibodies, colored yellow, shed on the surface of human lung cells.National Institute of Allergy and Infectious Diseases, NIH via AP file

RSV, or respiratory syncytial virus, is a common cause of cold-like symptoms, but it can be dangerous for infants and the elderly.

Last year, the U.S. Food and Drug Administration authorized single-dose RSV vaccines made by two companies, GSK and Pfizer, for older adults. At the time, vaccine advisers stopped short of saying all older Americans should get vaccinated because of questions about possible side effects and how long protection lasts.

Some of those questions still exist, and panel members on Wednesday rejected a request from vaccine makers to more forcefully recommend the shots to all Americans 60 and older.

Instead, they voted that people 75 and older should get vaccinated and that those 60 to 74 should only do so if they are at higher risk of serious illness. The panel also declined to approve giving the GSK vaccine to people in their 50s, even though the FDA authorized the company’s vaccine for that age group this month.

A newly approved RSV photo from Moderna will be subject to the same guidelines.

Panel members said the data demonstrated that the shots make sense for everyone 75 and older because they are at higher risk of severe cases of RSV.

For people 60 and older, conditions that put them at higher risk of serious illness include chronic heart disease, advanced kidney disease, chronic lung disease and severe obesity. About 39% of people in this age range would be eligible under the strictest interpretation of these guidelines, CDC officials said.

The committee also recommended the vaccine for people ages 60 to 74 who live in nursing homes or are considered frail by their doctors for other reasons.

Behind the panel’s hesitation are reports of a nervous system disorder, Guillain-Barré syndrome. Although rare, there have been a higher than expected number of Guillain-Barré cases among those vaccinated against RSV, particularly among those who received the Pfizer vaccine.

FDA officials said Wednesday that there was no clear evidence that the injections caused the disorder, but some panel members noted that research was ongoing.

“I agree with the overall conclusion that the risks of RSV vaccination are largely outweighed by the overall benefits,” said panel member Dr. Camille Kotton, an infectious disease expert at Massachusetts General Hospital. “I remain quite concerned,” however, about recurring indicators of Guillain-Barré in vaccination surveillance data, she added.

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