by Robin Foster
In new vaccination guidance issued Wednesday, U.S. health officials now recommend that all Americans aged 75 and older get an RSV vaccine before fall arrives.
However, those a bit younger—ages 60 to 74—should only seek the shot if they are vulnerable to severe RSV because of chronic medical conditions such as lung or heart disease, or if they live in nursing homes, the U.S. Centers for Disease Control and Prevention advised.
The recommendations came from a committee of CDC advisers and the agency has approved that guidance, making the advice official.
“The CDC has updated its RSV vaccination recommendation for older adults to prioritize those at highest risk for serious illness from RSV,” CDC Director Dr. Mandy Cohen said in an agency news release. “People 75 or older, or between 60-74 with certain chronic health conditions or living in a nursing home, should get one dose of the RSV vaccine to provide an extra layer of protection.”
The new guidelines only apply to adults who did not get an RSV vaccine last year, the CDC noted, because people do not need to get a shot every RSV season. The best time to get vaccinated is in late summer and early fall, before RSV starts spreading through the country, the agency added.
Just a year ago, the same CDC advisory panel recommended that people 60 and older simply talk to their doctors about whether to get the shots. Physicians have said the tepid recommendation confused patients and is probably why less than 25% of older Americans have gotten a RSV shot, the Associated Press reported.
RSV (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 licensed two single-dose RSV vaccines, made by GSK and Pfizer, for older people. At the time, the vaccine advisers refrained from saying that all older Americans should get the shots because of questions about possible side effects and the duration of protection, the AP reported.
Some of those questions remain, and on Wednesday panel members said no to a request by vaccine manufacturers to recommend the shots for all Americans aged 60 and older. The panel also declined to endorse giving the GSK vaccine to people in their 50s, even though the FDA this month licensed the company’s shot for that age group, the AP reported.
A newly approved RSV shot from Moderna will be subject to the same guidance.
Panel members said Wednesday that evidence has shown the shots make sense for all people 75 and older, because they are at higher risk for severe RSV. But they drew narrower guidelines for those aged 60 to 74.
Underlying the panel’s hesitancy are reports of a nervous system disorder, Guillain-Barre syndrome. Though rare, there have been a higher-than-expected number of Guillain-Barre cases among RSV vaccine recipients, particularly in those who got the Pfizer shot.
FDA officials noted Wednesday there is no clear evidence the shots are causing the disorder, but some panel members noted research is still ongoing.
“I do agree with the overall conclusion that the risks of RSV vaccination are greatly outweighed by the overall benefits,” said panel member Dr. Camille Kotton, an infectious diseases expert at Massachusetts General Hospital. “Nonetheless, I remain quite concerned” about recurring indicators of Guillain-Barre in vaccination surveillance data, she added.
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