The American College of Physicians (ACP) has issued a controversial recommendation that adults aged 75 and above should receive a protein subunit Respiratory Syncytial Virus (RSV) vaccine. This recommendation is based on a rapid review by the ACP Center for Evidence Reviews, which evaluated the efficacy, comparative effectiveness, and potential harms of RSV vaccines in adults aged 18 or older who are not pregnant or immunocompromised.
The ACP's Population Health and Medical Science Committee (PHMSC) concluded that the benefits of the protein subunit vaccines outweigh the harms in adults aged 75 and older. This is because RSV can cause severe lower respiratory tract infections in this age group, leading to hospitalization and even death. Annually, an estimated 170,000 adults aged 50 or older in the US are hospitalized due to RSV, with 14,000 deaths occurring. However, the benefits are less pronounced in adults aged 60-74, but the risks remain the same.
What's more, unlike other respiratory virus vaccines like influenza, an RSV vaccine is administered only once, and the need for repeat vaccination is still under study. This unique aspect of the RSV vaccine is a key factor in the ACP's recommendation, as it may reduce the burden of annual vaccination campaigns.
The ACP's recommendation has sparked debate, as some experts argue that the benefits of the vaccine may not outweigh the potential risks for all adults in this age group. Others suggest that the vaccine could be particularly beneficial for those with comorbid conditions, such as chronic kidney, liver, or lung disease, cardiovascular disease, hematologic conditions (like sickle cell disease), diabetes, obesity, or a combination of these conditions. This controversy invites further discussion and research to determine the most appropriate vaccination strategy for adults aged 75 and above.
