User login
For MD-IQ only
RSV Vaccine Effective in Older Veterans, But Protection Declines Over Time
RSV Vaccine Effective in Older Veterans, But Protection Declines Over Time
TOPLINE:
A single dose of respiratory syncytial virus (RSV) vaccine provided protection against RSV illness and associated health care use in nearly 290,000 older US veterans over 2 respiratory illness seasons compared with unvaccinated individuals; however, protection declined over time, particularly among immunocompromised individuals.
METHODOLOGY:
- Researchers emulated a target trial to assess the long-term effectiveness of a single does of RSV vaccine, administered between September 2023 and March 2024, to prevent RSV infection and associated health care use among older US veterans.
- The primary outcome was any positive RSV test from 14 days after vaccination; secondary outcomes included RSV-associated emergency department or urgent care visits, hospitalizations, and ICU admissions.
- The median follow-up duration, measured from 14 days after vaccination, was 15.8 months, with a maximum of 19.0 months.
TAKEAWAY:
- The estimated vaccines effectiveness against RSV infection decreased from 82.5% (95% CI, 77.5%-86.9%) over 0 to 1 month to 59.4% (95% CI, 55.6%-63.5%) over 0 to 18 months of follow-up.
- Protection against RSV-associated emergency department and urgent care visits fell from 84.9% over 0 to 1 month to 60.6% over 0 to 18 months, and the estimated effectiveness against hospitalizations decreased from 88.9% to 57.3% over the same interval.
- The estimated effectiveness against RSV-associated ICU admissions reduced from 92.5% (95% CI, 61.1%-100%) over 0 to 1 month to 71.9% (95% CI, 42.8%-90.0%) over 0 to 18 months.
- Among immunocompromised individuals, protection against RSV infection showed the largest decline from 75.2% at 0 to 1 month to 39.7% over 18 months.
IN PRACTICE:
"Boosters may be needed, but for now, our efforts should be focused on saving lives and decreasing disease by encouraging vaccination of persons 75 years and older and those 60 years and older with underlying health issues," experts wrote in an accompanying editorial.
SOURCE:
The study was led by Kristina L. Bajema, MD, Veterans Affairs Portland Health Care System, Portland, Oregon. It was published online on November 24, 2025, in JAMA Internal Medicine.
LIMITATIONS:
RSV documentation may have been incomplete for veterans who sought care outside the Veterans Health Administration. The cohort was predominantly White men, limiting generalizability. Residual confounding could not be excluded. Estimates of long-term effectiveness should be interpreted cautiously because they reflect patients who remained in care and may differ from the original matched cohort.
DISCLOSURES:
The study was supported by the US Department of Veterans Affairs Cooperative Studies Program, US Department of Health and Human Services, Biomedical Advanced Research and Development Authority, and FDA. Two authors reported receiving grants from the study funder and/or the Patient-Centered Outcomes Research Institute; one of these authors also reported co-ownership of van Breemen & Hynes, LLC, unrelated to the submitted work.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
A single dose of respiratory syncytial virus (RSV) vaccine provided protection against RSV illness and associated health care use in nearly 290,000 older US veterans over 2 respiratory illness seasons compared with unvaccinated individuals; however, protection declined over time, particularly among immunocompromised individuals.
METHODOLOGY:
- Researchers emulated a target trial to assess the long-term effectiveness of a single does of RSV vaccine, administered between September 2023 and March 2024, to prevent RSV infection and associated health care use among older US veterans.
- The primary outcome was any positive RSV test from 14 days after vaccination; secondary outcomes included RSV-associated emergency department or urgent care visits, hospitalizations, and ICU admissions.
- The median follow-up duration, measured from 14 days after vaccination, was 15.8 months, with a maximum of 19.0 months.
TAKEAWAY:
- The estimated vaccines effectiveness against RSV infection decreased from 82.5% (95% CI, 77.5%-86.9%) over 0 to 1 month to 59.4% (95% CI, 55.6%-63.5%) over 0 to 18 months of follow-up.
- Protection against RSV-associated emergency department and urgent care visits fell from 84.9% over 0 to 1 month to 60.6% over 0 to 18 months, and the estimated effectiveness against hospitalizations decreased from 88.9% to 57.3% over the same interval.
- The estimated effectiveness against RSV-associated ICU admissions reduced from 92.5% (95% CI, 61.1%-100%) over 0 to 1 month to 71.9% (95% CI, 42.8%-90.0%) over 0 to 18 months.
- Among immunocompromised individuals, protection against RSV infection showed the largest decline from 75.2% at 0 to 1 month to 39.7% over 18 months.
IN PRACTICE:
"Boosters may be needed, but for now, our efforts should be focused on saving lives and decreasing disease by encouraging vaccination of persons 75 years and older and those 60 years and older with underlying health issues," experts wrote in an accompanying editorial.
SOURCE:
The study was led by Kristina L. Bajema, MD, Veterans Affairs Portland Health Care System, Portland, Oregon. It was published online on November 24, 2025, in JAMA Internal Medicine.
LIMITATIONS:
RSV documentation may have been incomplete for veterans who sought care outside the Veterans Health Administration. The cohort was predominantly White men, limiting generalizability. Residual confounding could not be excluded. Estimates of long-term effectiveness should be interpreted cautiously because they reflect patients who remained in care and may differ from the original matched cohort.
DISCLOSURES:
The study was supported by the US Department of Veterans Affairs Cooperative Studies Program, US Department of Health and Human Services, Biomedical Advanced Research and Development Authority, and FDA. Two authors reported receiving grants from the study funder and/or the Patient-Centered Outcomes Research Institute; one of these authors also reported co-ownership of van Breemen & Hynes, LLC, unrelated to the submitted work.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
TOPLINE:
A single dose of respiratory syncytial virus (RSV) vaccine provided protection against RSV illness and associated health care use in nearly 290,000 older US veterans over 2 respiratory illness seasons compared with unvaccinated individuals; however, protection declined over time, particularly among immunocompromised individuals.
METHODOLOGY:
- Researchers emulated a target trial to assess the long-term effectiveness of a single does of RSV vaccine, administered between September 2023 and March 2024, to prevent RSV infection and associated health care use among older US veterans.
- The primary outcome was any positive RSV test from 14 days after vaccination; secondary outcomes included RSV-associated emergency department or urgent care visits, hospitalizations, and ICU admissions.
- The median follow-up duration, measured from 14 days after vaccination, was 15.8 months, with a maximum of 19.0 months.
TAKEAWAY:
- The estimated vaccines effectiveness against RSV infection decreased from 82.5% (95% CI, 77.5%-86.9%) over 0 to 1 month to 59.4% (95% CI, 55.6%-63.5%) over 0 to 18 months of follow-up.
- Protection against RSV-associated emergency department and urgent care visits fell from 84.9% over 0 to 1 month to 60.6% over 0 to 18 months, and the estimated effectiveness against hospitalizations decreased from 88.9% to 57.3% over the same interval.
- The estimated effectiveness against RSV-associated ICU admissions reduced from 92.5% (95% CI, 61.1%-100%) over 0 to 1 month to 71.9% (95% CI, 42.8%-90.0%) over 0 to 18 months.
- Among immunocompromised individuals, protection against RSV infection showed the largest decline from 75.2% at 0 to 1 month to 39.7% over 18 months.
IN PRACTICE:
"Boosters may be needed, but for now, our efforts should be focused on saving lives and decreasing disease by encouraging vaccination of persons 75 years and older and those 60 years and older with underlying health issues," experts wrote in an accompanying editorial.
SOURCE:
The study was led by Kristina L. Bajema, MD, Veterans Affairs Portland Health Care System, Portland, Oregon. It was published online on November 24, 2025, in JAMA Internal Medicine.
LIMITATIONS:
RSV documentation may have been incomplete for veterans who sought care outside the Veterans Health Administration. The cohort was predominantly White men, limiting generalizability. Residual confounding could not be excluded. Estimates of long-term effectiveness should be interpreted cautiously because they reflect patients who remained in care and may differ from the original matched cohort.
DISCLOSURES:
The study was supported by the US Department of Veterans Affairs Cooperative Studies Program, US Department of Health and Human Services, Biomedical Advanced Research and Development Authority, and FDA. Two authors reported receiving grants from the study funder and/or the Patient-Centered Outcomes Research Institute; one of these authors also reported co-ownership of van Breemen & Hynes, LLC, unrelated to the submitted work.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
A version of this article first appeared on Medscape.com.
RSV Vaccine Effective in Older Veterans, But Protection Declines Over Time
RSV Vaccine Effective in Older Veterans, But Protection Declines Over Time