Understanding the Risks of RSV in Older Adults
Respiratory Syncytial Virus (RSV) is a common respiratory virus that, for most healthy people, causes mild, cold-like symptoms. However, for older adults, especially those aged 80 and over, the risk of severe outcomes is substantially higher. The aging immune system can struggle to fight off the virus effectively, leading to more serious infections of the lower respiratory tract, like pneumonia or bronchiolitis. Furthermore, an RSV infection can worsen existing health problems, such as chronic heart and lung diseases, which are more prevalent in this demographic. Hospitalizations are a major concern, as they can lead to further complications like delirium, loss of independence, and increased frailty.
CDC's Clear Recommendation for Adults 75 and Older
The Centers for Disease Control and Prevention (CDC) provides clear and straightforward guidance on who should get vaccinated against RSV. The CDC recommends a single dose of any FDA-licensed RSV vaccine for all adults aged 75 and older. An 80-year-old falls directly into this highest-risk category, making vaccination a standard and important part of their preventative health plan. The recommendation is not based on shared clinical decision-making for this age group, but rather a universal guideline to provide maximum protection to those most vulnerable to severe disease.
Comparing the Available RSV Vaccines
As of recent approvals, there are three FDA-licensed RSV vaccines available for older adults. The CDC does not have a preferential recommendation for any specific vaccine, so eligible adults can receive any of the licensed options. Here is a comparison of the three major options:
| Feature | GSK (Arexvy) | Pfizer (Abrysvo) | Moderna (mResvia) |
|---|---|---|---|
| Recommended Age | Adults 75+ (and 50-74 at increased risk) | Adults 75+ (and 50-74 at increased risk) | Adults 75+ (and 50-74 at increased risk) |
| Technology | Recombinant protein with an adjuvant | Recombinant protein | mRNA |
| Dosage | Single dose | Single dose | Single dose |
| Effectiveness (Severe) | High, around 83% efficacy against hospitalization for adults 60+ in initial real-world data | High, around 73% efficacy against hospitalization for adults 60+ in initial real-world data | High, around 80% efficacy in clinical trials (first 4 months) |
| Monitoring for GBS | Yes, risk is monitored post-licensure | Yes, risk is monitored post-licensure | Yes, risk is monitored post-licensure |
All three vaccines are considered highly effective in preventing severe illness. The choice of vaccine may come down to availability, patient preference, and discussion with a healthcare provider.
Weighing the Benefits vs. Risks for an 80-Year-Old
For an 80-year-old, the potential benefits of getting the RSV vaccine far outweigh the potential risks. Here’s a closer look at the considerations:
The Benefits of Vaccination
- Prevents severe disease: Clinical trial and real-world data show high effectiveness against severe RSV-associated lower respiratory tract disease, significantly reducing the likelihood of hospitalization and death.
- Reduces hospitalization risk: Studies confirm that vaccinated older adults are substantially less likely to be hospitalized for RSV compared to their unvaccinated peers.
- Maintains quality of life: By preventing severe illness, vaccination helps older adults avoid the negative impacts of hospitalization, such as cognitive decline, physical weakness, and loss of independence.
Addressing Potential Risks
- Common side effects: Like most vaccines, side effects are generally mild and temporary, and may include pain at the injection site, fatigue, headache, or muscle pain.
- Guillain-Barré syndrome (GBS): While a small number of GBS cases were reported in post-licensure monitoring for the Arexvy and Abrysvo vaccines, the CDC has concluded that the overall benefits of vaccination outweigh this potential risk for the recommended age groups. Ongoing safety monitoring continues for all vaccines, including mResvia.
Timing and Co-administration with Other Vaccines
An 80-year-old can receive an RSV vaccine at any time of year. However, the best time to get vaccinated is in late summer or early fall, before the typical RSV season begins. In most of the U.S., this means getting the shot between August and October. The RSV vaccine is not currently recommended as an annual shot; one single dose is recommended for eligible individuals.
For convenience, the RSV vaccine can be safely administered at the same visit as other vaccines, such as the annual flu shot or the COVID-19 vaccine. A provider can help determine the best plan for multi-vaccine appointments based on the individual's needs and health status.
Important Considerations for Your Discussion with a Doctor
Before receiving the RSV vaccine, it is always best for an 80-year-old and their caregivers to have a conversation with a healthcare provider. This allows for a comprehensive assessment of any specific health conditions or concerns. During this conversation, a patient might discuss their medical history, including any chronic conditions like heart or lung disease, or a history of neurological disorders like GBS. For more detailed information on recommendations and vaccine safety, a good resource is the Centers for Disease Control and Prevention.
Conclusion
For anyone asking, "Should an 80 year old get the RSV vaccine?", the answer, based on authoritative health guidance, is a resounding yes. Given the high risk of severe complications from RSV in older adults, a single dose of one of the three available vaccines provides crucial protection against hospitalization and death. For an 80-year-old, receiving the RSV vaccine is a critical step in safeguarding their health and maintaining their independence, with benefits that far outweigh the potential for mild side effects.
