Targeting RSV in high-risk populations after a new study published in JAMDA1 found that adults living in long-term care facilities (LTCFs) produced strong antibody responses. Vaccines recommended for use.
RSV is a major respiratory infection that primarily affects pediatric patients and the elderly. There is no approved treatment for RSV in adults, but two vaccines were approved by the FDA in 2023 for use in adults 60 years and older2,3. The trials that formed the basis for the approval of these vaccines focused primarily on healthy older adults. As a result, they may have overlooked the potential impact of vaccines on older adults in poor health living in LTCFs. This study aimed to evaluate the short-term immune response of RSV vaccine in an elderly population aged 60 years and older living in LTCFs compared to healthy older adults.
All participants received either the Pfizer or GSK RSV vaccine as part of their daily care. All participants were from the University of Rochester Medical Center Infectious Disease Research Clinic and its two local LTCFs. All adults received the vaccine in November or December 2023. LTCF A received the GSK vaccine, while LTCF B received the Pfizer vaccine. All medical and demographic data were collected at enrollment.
Older adults living in long-term care facilities have been shown to have an antibody response to respiratory syncytial virus vaccination | Image credit: Melinda Nagy – Stock.adobe.com
Participants were included if they were aged 60 years or older, lived independently in an LTCF residence or in the community, had a life expectancy of 6 months or more, planned to be vaccinated, and provided consent. Patients with a history of immunosuppression or medications; patients who received routine vaccination within 14 days before or after a planned RSV vaccine; patients with a history of hypersensitivity; administration of blood or plasma products within 60 days of vaccination. Patients who received the vaccine or who had previously been vaccinated were excluded. received vaccination outside the study or had an RSV infection within 2 months after the study.
The study included 152 participants, of whom 76 were LTCF residents and 76 were community older adults. The Pfizer vaccine was administered to half of the LTCF residents, while the GSK vaccine was administered to the other half. Those receiving the Pfizer vaccine were significantly older than those receiving the GSK vaccine (78.2 years vs. 73.8 years). Participants living in LTCFs were also older compared to the community cohort (79.6 years vs. 72.6 years).
There were 146 participants with evaluable data. Among these participants, A2 strain (FA), B1 strain (FB), and microneutralization assay A2, respectively. Geometric mean increases in FA in the clinic and LTCF cohorts were 9.9 and 12.5, respectively. FB was 8.7 and 11.0. RSV A2 was 12.8 and 15.5. There were no significant differences in geometric mean titer responses based on vaccine received.
The study had several limitations. The sample size was smaller and the regional cohort used in this study was older than the study population found in the phase 3 trial, which may have reduced the differences in immunological responses between the two groups. Selection bias may occur because adults with LTCF must choose whether to be vaccinated. The exclusion created an imbalance in the Pfizer and GSK vaccines administered to residents living in LTCFs.
The researchers concluded that these results demonstrate that the RSV vaccine can be administered to high-risk adults and all will see strong antibody responses. Future research will need to corroborate these results to ensure safety when distributing the vaccine to adults aged 60 years and older living in LTCFs.
References
Falsey AR, Branche AR, Peasley M, et al. Short-term immunogenicity of licensed subunit RSV vaccines in residents of long-term care facilities (LTCFs) compared to community-dwelling older adults. J Am Med Dir Assoc. Published online on September 21, 2024. doi:10.1016/j.jamda.2024.105281Bonavitacola J. First respiratory syncytial virus vaccine approved by the FDA. AJMC®. May 3, 2023. Accessed September 26, 2024. https://www.ajmc.com/view/first-respiratory-syncytial-virus-vaccine-approved-by-fdaU.S. FDA recommends Pfizer’s vaccine Abrysvo to prevent respiratory syncytial virus (RSV) in older adults. approved. News release. Pfizer. May 31, 2023. Accessed September 26, 2024. https://www.pfizer.com/news/press-release/press-release-detail/us-fda-approves-abrysvotm-pfizers-vaccine-prevention
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