How Effective Is the RSV Vaccine in Older Adults?

The adjuvanted, post-fusion F protein-based respiratory syncytial virus (RSV) vaccine does not prevent RSV in older adults, according to a recent study.

For their study, the researchers assessed a per-protocol population of 1894 patients age 60 years or older. Patients were randomly assigned to receive either 120 µg RSV post-fusion F protein with 5 µg glucopyranosyl lipid adjuvant in 2% stable emulsion or placebo. All patients received the influenza vaccine.
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Patients who were ill recorded their symptoms and provided blood samples and nasal swabs.

Results indicated that RSV-acute respiratory infections (RSV-ARI) occurred at 14 days or later post-dosing in 1.7% of patients who received the vaccine, and 1.6% of patients on placebo, with a vaccine efficacy (VE) of -7.1%. The researchers did not observe efficacy in secondary analyses, which included seroresponse to nonvaccine RSV antigens (VE, 8.9%) or symptoms combined with seroresponse (VE, 10.0%).

A total of 92.9% of vaccines had demonstrated an anti-F immunoglobulin G antibody seroresponse at day 29. Overall, 48.5% of those who received the RSV vaccine reported local symptoms, while 30.9% of vaccine recipients systemic solicited symptoms.

“The RSV vaccine was immunogenic but did not protect older adults from RSV illness,” the researchers concluded.

—Christina Vogt

Reference:

Falloon J, Yu J, Esser MT, et al. An adjuvanted, postfusion F protein-based vaccine did not prevent respiratory syncytial virus illness in older adults [Published online September 23, 2017]. J Infect Dis. https://doi.org/10.1093/infdis/jix503.