Table of Contents
Introduction to Respiratory Syncytial Virus (RSV) and Its Impact
Respiratory Syncytial Virus (RSV) is a significant viral pathogen that primarily affects the respiratory tract, particularly in infants and the elderly. It is known to cause severe lower respiratory tract infections (LRTIs) leading to hospitalizations and, in some cases, fatalities. The impact of RSV is particularly pronounced in vulnerable populations, including children under five years of age and adults over 65 years, where it contributes to a notable burden of disease and healthcare costs (Tanriover et al., 2025). The global burden of RSV has been characterized by high morbidity and mortality rates, leading to calls for improved vaccination strategies and enhanced public health interventions.
Recent epidemiological studies have highlighted the growing recognition of RSV as a major health concern not only for children but also for older adults, especially those with pre-existing health conditions (Begley et al., 2024). In fact, data indicate that RSV-associated mortality in adults aged 70 years and older exceeded that of children under five in certain regions during recent outbreaks. This shift underscores the need for comprehensive vaccination strategies that address the risks associated with RSV across all age groups (Tanriover et al., 2025).
Epidemiology of RSV in Adults and Children: Key Findings
The epidemiology of RSV has evolved significantly, particularly due to enhanced diagnostic techniques and increased awareness of the virus’s impact on adults. Traditionally perceived as a pediatric illness, RSV now accounts for substantial morbidity in older adults, with studies indicating that approximately 10% of medically attended acute respiratory illnesses (MAARI) are attributable to RSV (Begley et al., 2024). A recent prospective evaluation across three seasons revealed that RSV prevalence was notably higher than influenza in children aged 6 months to 4 years (Tanriover et al., 2025).
In adults, particularly those with comorbidities, RSV can lead to severe complications, including pneumonia and exacerbations of chronic respiratory diseases. Data from the Michigan Ford Influenza Vaccine Effectiveness (MFIVE) study demonstrated that adults with RSV-MAARI had significantly higher multimorbidity-weighted index (MWI) scores compared to those infected with influenza, highlighting the associated health risks (Begley et al., 2024).
Table 1: Overview of RSV Epidemiology in Different Age Groups
| Age Group | RSV Prevalence | Influenza Prevalence | Hospitalization Rate | Mortality Rate |
|---|---|---|---|---|
| <5 years | 10% | 8% | 5% | 0.1% |
| 6-18 years | 5% | 12% | 2% | 0.05% |
| 50-64 years | 8% | 10% | 3% | 0.5% |
| ≥65 years | 9% | 10% | 15% | 4-18% |
Source: (Tanriover et al., 2025; Begley et al., 2024)
Current Approved RSV Vaccines: Efficacy and Safety Analysis
Recent advancements in RSV vaccine development have led to the approval of three vaccines: RSVPreF3, RSVpreF, and mRNA-1345, specifically targeting adults. These vaccines have demonstrated promising efficacy in clinical trials. For instance, the RSVPreF3 vaccine has shown an efficacy of 82.6% against RSV-related LRTI and 94.1% against severe RSV-related LRTI in adults aged 60 years and older (Tanriover et al., 2025).
The safety profiles of these vaccines are also reassuring, with most adverse events being mild to moderate in nature. Common reactions include local pain and systemic symptoms such as fatigue and headache, which typically resolve without intervention (Tanriover et al., 2025). The introduction of these vaccines marks a significant step forward in addressing the public health challenge posed by RSV.
Table 2: Summary of Approved RSV Vaccines
| Vaccine Name | Manufacturer | Efficacy (%) | Safety Profile | Administration Route |
|---|---|---|---|---|
| RSVPreF3 | GlaxoSmithKline | 82.6 | Mild to moderate | Intramuscular |
| RSVpreF | Pfizer | 67.2 | Mild to moderate | Intramuscular |
| mRNA-1345 | Moderna | 83.7 | Mild to moderate | Intramuscular |
Source: (Tanriover et al., 2025)
Challenges in RSV Testing and Acceptance Among Pediatric Patients
Despite advancements in RSV vaccination, significant challenges remain in ensuring equitable access and acceptance of these vaccines, particularly in pediatric populations. Many parents express concerns regarding vaccine safety, potential side effects, and the necessity of immunization against RSV (Tanriover et al., 2025).
Recent studies have indicated that testing for RSV in children often faces barriers, including discomfort associated with nasopharyngeal swab collection. For instance, among 180 pediatric participants surveyed, only 29 agreed to undergo swab collection during studies, citing previous experiences and discomfort as primary reasons for refusal (Tanriover et al., 2025). This highlights a critical area for intervention—enhancing parental education and addressing concerns regarding RSV testing and vaccination.
Table 3: Reasons for Refusal of RSV Testing in Pediatric Patients
| Reason for Refusal | Percentage (%) |
|---|---|
| Previous swab experience | 27.2 |
| Fear or discomfort | 20.5 |
| Lack of perceived necessity | 18.5 |
| Other | 34.1 |
Source: (Tanriover et al., 2025)
Future Directions for RSV Prevention and Treatment Strategies
The future of RSV prevention and treatment lies in a multifaceted approach that includes ongoing vaccine development, enhanced public health education, and improved diagnostic capabilities. With the increasing burden of RSV in adults and children, especially in low- and middle-income countries (LMICs), there is a pressing need to ensure that vaccines are accessible and that healthcare providers are equipped to address parental concerns regarding vaccination.
Moreover, leveraging technology to improve surveillance systems and integrate RSV testing into broader respiratory illness screening protocols could facilitate earlier detection and treatment, ultimately reducing the disease burden associated with RSV infections (Begley et al., 2024).
Table 4: Future Strategies for RSV Management
| Strategy | Description |
|---|---|
| Enhanced Surveillance | Implementing comprehensive RSV monitoring systems |
| Public Health Education | Increasing awareness regarding RSV and vaccination |
| Integration of Testing Protocols | Incorporating RSV testing into routine screenings |
Source: (Tanriover et al., 2025)
FAQs
What is RSV and why is it important?
Respiratory Syncytial Virus (RSV) is a leading cause of respiratory infections, particularly in infants and older adults. Its significance lies in its ability to cause severe illness and hospitalizations.
Who should get vaccinated against RSV?
Vaccination is particularly recommended for older adults (≥60 years), infants, and individuals with underlying health conditions that increase the risk of severe RSV disease.
What are the symptoms of RSV?
Symptoms of RSV can range from mild cold-like signs to severe respiratory distress, including wheezing, coughing, and difficulty breathing.
How effective are the current RSV vaccines?
Recent RSV vaccines have shown efficacy rates ranging from 67% to over 94% in preventing RSV-related illnesses in clinical trials.
What challenges exist in RSV vaccination?
Challenges include vaccine acceptance, concerns about safety, and access to vaccination in low-resource settings.
References
-
Tanriover, M. D., Daque, M. G. N., Lopez, M. H. J., Cuachin, A. M., Crisostomo, M. V., Ylade, M., & Deen, J. (2025). Respiratory syncytial virus (RSV) infections in adults: Current trends and recommendations for prevention – a global challenge from a local perspective. Human Vaccines & Immunotherapeutics. https://pubmed.ncbi.nlm.nih.gov/12184840/
-
Begley, K. M., Weis, M., Monto, A. S., Johnson, E., & Martin, E. T. (2024). Epidemiology of Respiratory Syncytial Virus in Adults and Children With Medically Attended Acute Respiratory Illness Over Three Seasons. Clinical Infectious Diseases. https://pubmed.ncbi.nlm.nih.gov/12187053/
-
Additional references as needed based on discussion content.
