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. 2024 Oct;15(5):1215-1229.
doi: 10.1007/s41999-024-01066-y. Epub 2024 Sep 26.

Efficacy of anti-RSV vaccination in preventing respiratory syncytial virus disease and severe illness in older adults: a systematic review of randomized controlled trials

Ana Catarina Moreira  1 , Ana Beatriz Ribeiro  2 , Inês Oliveira  3 , Mariana Sá  3 , Catarina Lameirão  3 , Patrícia Marques  3
Affiliations

Efficacy of anti-RSV vaccination in preventing respiratory syncytial virus disease and severe illness in older adults: a systematic review of randomized controlled trials

Ana Catarina Moreira et al. Eur Geriatr Med. 2024 Oct.

Abstract

Purpose: Several vaccines against respiratory syncytial virus (RSV) are being developed. The objective of this systematic review is to determine the efficacy of these vaccines in preventing RSV disease in adults over 60 years of age, especially regarding severe illness.

Methods: We researched MEDLINE, CENTRAL, Scopus, medRxiv, bioRxiv and ClinicalTrials.gov until April/2024. Randomized controlled trials studying an anti-RSV vaccine in adults above 60 years and reporting RSV-related acute respiratory infection/disease (ARI/ARD), lower respiratory tract infection/disease (LRTI/LRTD) and severe LRTI/LRTD were included. Vaccine efficacy was calculated as ([1 - risk ratio] × 100). Risk of bias and certainty of evidence were assessed by RoB2 tool and GRADE approach. The meta-analytical relative risk of ARI/ARD and LRTI/LRTD was estimated, with a subgroup analysis performed according to the vaccine type. The random effects model was used.

Results: We included seven studies, five addressing prefusion vaccines and two regarding non-prefusion ones. The number of RSV-related LRTI/LRTD cases was reduced by vaccination, with a relative risk of 0.39 [CI 95% 0.22 to 0.69] and a vaccine efficacy of 61%. Considering the subgroup of prefusion vaccines alone, there is a relative risk of 0.27 [CI 95% 0.19 to 0.36] for LRTI/LRTD and a vaccine efficacy of 73%. ARI/ARD incidence presented a similar pattern. Only one trial reports results for severe LRTI/LRTD, with a vaccine efficacy of 94.1% [95% CI 62.4 to 99.9].

Conclusions: Prefusion anti-RSV vaccines are efficacious in the prevention of LTRI/LTRD and ARI/ARD cases. More studies regarding severe LTRI/LTRD are necessary in the future.

Keywords: Adults; Efficacy; RSV; Respiratory syncytial virus vaccines; Vaccine.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflict of interest. There are no sponsors or financial support to be declared. Ethical approval: This review was registered in PROSPERO (International prospective register of systematic reviews) under the number CRD42024559694. A protocol was prepared and is available upon request. Informed consent: All the studies included in this review obtained informed consent from all the individual participants. Our research did not directly involve human subjects, but additional informed consent was obtained if necessary.

References

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