Respiratory Syncytial Virus Vaccination Among US Adults Aged ≥60 Years

Overview

Journal Front Immunol

Specialty Allergy & Immunology

Date 2024 Dec 18

PMID 39691711

Authors

Xiaozhen Geng

Wenjun Wang

Affiliations

Soon will be listed here.

Abstract

Background: Respiratory syncytial virus (RSV) vaccines have been recommended for US adults aged ≥60 years for nearly one year. However, the extent of vaccination coverage and the factors influencing uptake remain underexplored. This study aimed to evaluate national and state-specific RSV vaccination coverage among US adults aged ≥60 years and to identify demographic and socioeconomic factors that influence vaccination uptake.

Methods: This cross-sectional study analyzed data from the US Census Household Pulse Survey, from January 9 to March 4, 2024, which included 49,322 adults aged ≥60 years. Participants self-reported their RSV vaccination status along with demographic and socioeconomic information. Multivariable Poisson regression was used to identify factors associated with vaccination uptake.

Results: As of March 4, 2024, RSV vaccination coverage among US adults aged ≥60 years was estimated at 22.2% (95% CI, 21.6%-22.7%). State-specific vaccination coverage ranged from 12.4% in Mississippi to 33.1% in Colorado. Coverage was higher in older age groups, with 21.2% among those aged 65-69 years, 28.1% among 70-74 years, 31.9% among 75-79 years, and 30.2% among those aged ≥80 years, compared to 10.8% among those aged 60-64 years. Racial/ethnicity disparities were evident, with lower coverage among Hispanics (18.3%) and non-Hispanic Blacks (17.6%) compared to non-Hispanic Whites (23.3%). Coverage was similar between males (22.6%) and females (21.8%). Factors positively associated with vaccination included older age, higher education level, higher household income, unemployment, and residing in the Midwest or West. Conversely, being non-Hispanic Black, uninsured, experiencing financial difficulties, and lack of COVID-19 vaccination were associated with reduced likelihood of receiving the RSV vaccine.

Conclusions: During the first RSV season after the recommendations for RSV vaccination in US adults aged ≥60 years, uptake shows promise but is marked by significant disparities related to race/ethnicity, socioeconomic status, and geographic location. Efforts to address these disparities are crucial to enhance vaccination coverage and reduce the impact of RSV on this vulnerable population.

References

Prasad N, Walker T, Waite B, Wood T, Trenholme A, Baker M . Respiratory Syncytial Virus-Associated Hospitalizations Among Adults With Chronic Medical Conditions. Clin Infect Dis. 2020; 73(1):e158-e163. DOI: 10.1093/cid/ciaa730. View

Wilson E, Goswami J, Baqui A, Doreski P, Perez-Marc G, Zaman K . Efficacy and Safety of an mRNA-Based RSV PreF Vaccine in Older Adults. N Engl J Med. 2023; 389(24):2233-2244. DOI: 10.1056/NEJMoa2307079. View

Britton A, Roper L, Kotton C, Hutton D, Fleming-Dutra K, Godfrey M . Use of Respiratory Syncytial Virus Vaccines in Adults Aged ≥60 Years: Updated Recommendations of the Advisory Committee on Immunization Practices - United States, 2024. MMWR Morb Mortal Wkly Rep. 2024; 73(32):696-702. DOI: 10.15585/mmwr.mm7332e1. View

Williams W, Lu P, OHalloran A, Kim D, Grohskopf L, Pilishvili T . Surveillance of Vaccination Coverage Among Adult Populations - United States, 2014. MMWR Surveill Summ. 2016; 65(1):1-36. DOI: 10.15585/mmwr.ss6501a1. View

Lu P, OHalloran A, Williams W, Harpaz R . National and State-Specific Shingles Vaccination Among Adults Aged ≥60 Years. Am J Prev Med. 2016; 52(3):362-372. PMC: 5818280. DOI: 10.1016/j.amepre.2016.08.031. View

Ackerson B, An J, Sy L, Solano Z, Slezak J, Tseng H . Cost of Hospitalization Associated With Respiratory Syncytial Virus Infection Versus Influenza Infection in Hospitalized Older Adults. J Infect Dis. 2020; 222(6):962-966. DOI: 10.1093/infdis/jiaa183. View

Kawai K, Kawai A . Racial/Ethnic and Socioeconomic Disparities in Adult Vaccination Coverage. Am J Prev Med. 2021; 61(4):465-473. DOI: 10.1016/j.amepre.2021.03.023. View

Papi A, Ison M, Langley J, Lee D, Leroux-Roels I, Martinon-Torres F . Respiratory Syncytial Virus Prefusion F Protein Vaccine in Older Adults. N Engl J Med. 2023; 388(7):595-608. DOI: 10.1056/NEJMoa2209604. View

McLellan J . Neutralizing epitopes on the respiratory syncytial virus fusion glycoprotein. Curr Opin Virol. 2015; 11:70-5. PMC: 4456247. DOI: 10.1016/j.coviro.2015.03.002. View

10.

Moghadas S, Shoukat A, Bawden C, Langley J, Singer B, Fitzpatrick M . Cost-effectiveness of Prefusion F Protein-based Vaccines Against Respiratory Syncytial Virus Disease for Older Adults in the United States. Clin Infect Dis. 2023; 78(5):1328-1335. PMC: 11093660. DOI: 10.1093/cid/ciad658. View

11.

Hurley L, Allison M, Kim L, OLeary S, Crane L, Brtnikova M . Primary care physicians' perspectives on respiratory syncytial virus (RSV) disease in adults and a potential RSV vaccine for adults. Vaccine. 2019; 37(4):565-570. DOI: 10.1016/j.vaccine.2018.12.031. View

12.

Melgar M, Britton A, Roper L, Talbot H, Long S, Kotton C . Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices - United States, 2023. MMWR Morb Mortal Wkly Rep. 2023; 72(29):793-801. PMC: 10360650. DOI: 10.15585/mmwr.mm7229a4. View

13.

Van Effelterre T, Hens N, White L, Gravenstein S, Bastian A, Buyukkaramikli N . Modeling Respiratory Syncytial Virus Adult Vaccination in the United States With a Dynamic Transmission Model. Clin Infect Dis. 2023; 77(3):480-489. DOI: 10.1093/cid/ciad161. View

14.

Black C, Kriss J, Razzaghi H, Patel S, Santibanez T, Meghani M . Influenza, Updated COVID-19, and Respiratory Syncytial Virus Vaccination Coverage Among Adults - United States, Fall 2023. MMWR Morb Mortal Wkly Rep. 2023; 72(51):1377-1382. PMC: 10754266. DOI: 10.15585/mmwr.mm7251a4. View

15.

Boyoglu-Barnum S, Chirkova T, Anderson L . Biology of Infection and Disease Pathogenesis to Guide RSV Vaccine Development. Front Immunol. 2019; 10:1675. PMC: 6677153. DOI: 10.3389/fimmu.2019.01675. View

16.

Walsh E, Marc G, Zareba A, Falsey A, Jiang Q, Patton M . Efficacy and Safety of a Bivalent RSV Prefusion F Vaccine in Older Adults. N Engl J Med. 2023; 388(16):1465-1477. DOI: 10.1056/NEJMoa2213836. View

17.

Herring W, Zhang Y, Shinde V, Stoddard J, Talbird S, Rosen B . Clinical and economic outcomes associated with respiratory syncytial virus vaccination in older adults in the United States. Vaccine. 2021; 40(3):483-493. DOI: 10.1016/j.vaccine.2021.12.002. View

18.

Ngwuta J, Chen M, Modjarrad K, Joyce M, Kanekiyo M, Kumar A . Prefusion F-specific antibodies determine the magnitude of RSV neutralizing activity in human sera. Sci Transl Med. 2015; 7(309):309ra162. PMC: 4672383. DOI: 10.1126/scitranslmed.aac4241. View

19.

Granade C, Lindley M, Jatlaoui T, Asif A, Jones-Jack N . Racial and Ethnic Disparities in Adult Vaccination: A Review of the State of Evidence. Health Equity. 2022; 6(1):206-223. PMC: 8985539. DOI: 10.1089/heq.2021.0177. View