Well known as a major cause of bronchiolitis in infants, respiratory syncytial virus (RSV) can also cause serious complications, even death, in the elderly. This is why the High Authority for Health (HAS) recommended, this Thursday, July 4, the vaccination of older French people with one or the other of the two vaccines available against the main virus causing this infection.
While no treatment for RSV respiratory infections existed until last year, two vaccines have recently obtained marketing authorization (MA) for seniors: Arexvy (GSK) and Abrysvo (Pfizer). After evaluation, the HAS “recommends vaccinating, with one or the other of these vaccines, people aged 75 and over, as well as people aged 65 and over with chronic respiratory or cardiac pathologies”, according to a press release.
If the Minister of Health – present or future – follows the HAS recommendation, as is generally the case, these vaccinations could be covered by health insurance. Those aged 75 and over are “particularly vulnerable” to RSV, the health authority explained. In France, during the 2022-2023 winter season, this category represented 61% of hospitalizations and 78% of deaths linked to RSV. In addition, studies in the United Kingdom and the United States have shown the importance of this virus as a cause of morbidity and mortality in those aged 75 and over, regardless of risk factors, the health authority specified.
Reduction of infections
As for those aged 65 and over, vaccination is recommended only for those with chronic respiratory diseases (particularly chronic obstructive pulmonary disease, COPD) or chronic cardiac diseases (particularly heart failure), “likely to worsen during an RSV infection”.
The HAS took into account the efficacy data of the two vaccines on lower respiratory tract infections in those aged 60 and over, which in particular “showed a reduction in these infections of 83% for Arexvy and 67 to 86% for Abrysvo depending on the criterion used (2 or 3 symptoms)”. It also relied on the available safety and tolerance data.
The HAS will reassess its recommendation once certain data has been consolidated, concerning the real-life effectiveness of these vaccines on hospitalizations and deaths attributable to RSV infections, the expected benefit in other populations, particularly in immunocompromised patients, and pharmacovigilance. Several dozen doctors had called, at the end of last September, for this vaccination to be made available quickly. To the criticisms on the slow evaluation of certain vaccines, such as the one against RSV infection in seniors, the HAS had opposed the delays necessary for its rigorous recommendations.