In the first season with respiratory syncytial virus vaccination availability for older adults in the United States, only 10.4% of eligible hospitalized patients aged 60 years and older received the shot.
A study of 6,746 adults hospitalized across 26 hospitals in 20 states during the 2023–2024 respiratory virus season identified major gaps in both vaccine coverage and awareness.
The analysis focused on adults hospitalized with respiratory syncytial virus (RSV)-negative acute respiratory illness between October 2023 and April 2024. Investigators examined characteristics associated with vaccine receipt, including age, sex, race and ethnicity, chronic health conditions, insurance status, educational attainment, and community social vulnerability.
Adults aged 75 and older were more likely to be vaccinated than those aged 60 to 74. Men had higher vaccination rates than women. Patients with chronic pulmonary disease or immunocompromised status were also more likely to be vaccinated. Higher education levels and residence in communities with lower social vulnerability were associated with a higher likelihood of vaccination; in contrast, long-term care facility residents and those with Medicaid or no insurance were significantly less likely to be vaccinated. Higher levels of educational attainment showed a strong association with receipt: patients who had attended four or more years of college were nearly three times as likely to be vaccinated as those who had not completed high school.
Among 3,219 unvaccinated patients who responded to interview questions, nearly half had not heard of RSV. Most were unsure about their vaccine eligibility or believed they were not eligible. Awareness was particularly low among those with less education and those living in areas of high social vulnerability.
Among vaccinated patients, the most common reasons reported for receiving the vaccine were concern for personal health and physician recommendation. Of the unvaccinated group, 41.7% reported being open to vaccination in the future, and more than half of those wanted to consult their physician before doing so.
Researchers also found that individuals who had received their COVID-19 or influenza vaccines during the same virus season were more likely to have also received the RSV vaccine, suggesting prior vaccination behavior may influence RSV vaccine uptake.
Because the RSV vaccine was introduced under a shared clinical decision-making model rather than a universal recommendation, the researchers noted this could have complicated implementation. Many patients preferred to receive their vaccination at their physician’s office, but the vaccine was often only available at pharmacies due to Medicare coverage under Part D.
The findings highlight several barriers to vaccine uptake, including low awareness, limited access in clinical settings, and socioeconomic disparities. The investigators called for continued monitoring and targeted outreach to improve uptake in future seasons, especially as updated guidance now recommends RSV vaccination for all adults aged 75 and older and for those aged 60 to 74 at increased risk.
Full disclosures are available in the study.
Source: JAMA Network Open