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This systematic review aimed to assess the efficacy of various respiratory syncytial virus (RSV) vaccines in preventing RSV disease, particularly severe illness, in adults aged 60 and older.
Prefusion RSV vaccines exhibit strong efficacy in protecting older adults from respiratory infections.
This systematic review aimed to assess the efficacy of various respiratory syncytial virus (RSV) vaccines in preventing RSV disease, particularly severe illness, in adults aged 60 and older.
Searches were executed across the Cochrane Central Register of Controlled Trials (CENTRAL), bioRxiv, medRxiv, MEDLINE, Scopus by Elsevier and ClinicalTrials.gov until April 2024. The randomized trials that evaluated an anti-RSV vaccine in older adults were included. These trials concentrated on outcomes related to RSV-associated acute respiratory infection/disease (ARI/D), lower respiratory tract infection/disease (LRTI/D), and severe cases of LRTI/D were included.
Vaccine efficacy was determined and the bias risk and evidence certainty were assessed using the risk of bias in randomized trials (RoB 2) tool and the GRADE approach. The relative risk of ARI/D and LRTI/D, with a subgroup analysis based on the type of vaccine, was estimated via a random effects model.
Seven studies (5 focusing on prefusion; and 2 on non-prefusion vaccines) were included. The number of RSV-related cases of LRTI/D was considerably reduced with the use of vaccination, representing a relative risk (RR) of 0.39 and vaccine efficacy of 61%.
Prefusion vaccines had a vaccine efficacy of 73% and the RR for LRTI/D was 0.27. A similar tendency concerning the incidence of ARI/ARD was also observed. Additionally, a trial reported a vaccine efficacy of 94.1% for severe LRTI/D.
Prefusion anti-RSV vaccines effectively prevent the cases of LRTI/D and ARI/D. Future investigation is required for a better understanding of their impact on severe LRTI/D.
European Geriatric Medicine
Efficacy of anti-RSV vaccination in preventing respiratory syncytial virus disease and severe illness in older adults: a systematic review of randomized controlled trials
Ana Catarina Moreira et al.
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