I am personally aware of the impact of RSV on infants with 1-3% of children in the USA hospitalized each year. The threat of RSV to older adults has become clear over the last decade as better diagnostic point of care tests have become available. The CDC reports the adverse impact of this seasonal virus to be like influenza with 60,000 to 160,000 hospitalizations and 6,000-10,000 deaths each year in those over 65. The risk is high for those over 75 and those with high-risk chronic diseases. These are the same diseases that also confer higher risk for those who acquire Influenza or Covid-19.

In 2023, three vaccines for RSV were approved. Two are subunit RSV Vaccines (do not require cold storage) and one is an mRNA vaccine. With close monitoring through the VAERS (Vaccine Adverse Reporting System) and VSD (Vaccine Safety Datalink), we now have more safety and effectiveness data for these vaccines. A small signal for Guillain Barre syndrome has been reported with the subunit RSV vaccines (like what we see with influenza vaccines), which is why the CDC recommends it for all those ages 75 and older, and for those 60-74 with risk factors including residing in a nursing home or assisted living. Therefore essentially all our residents ages 60 and up should be given the vaccine.. Because RSV, like influenza, is more active in the late Fall and Winter, early fall is a suitable time to promote this vaccine along with your influenza and new COVID update vaccines. Currently, the RSV vaccine is a once-in-a-lifetime vaccine.

CALTCM’s Office Hours with the Experts on July 25, 2024, focused on the RSV vaccine and is an excellent resource for detailed information on this important advance in health care. This information is available on our website for members as a pdf handout and video recording. In addition, the AGS (American Geriatric Society) has developed basic and beyond the basic information for patients regarding this important advance (below links).

As of March 30, 2024, only 20.4% of adults over 65 in California had received an RSV vaccine. We know that vaccine skepticism has become more prevalent since the COVID pandemic but a strong recommendation from a trusted provider combined with patient-friendly handouts can move the needle on vaccine acceptance. I found the approach to vaccine hesitancy of Dr. Grace Hassid in the CALTCM experts session video (below Link), to be quite helpful.
This vaccine is covered for those with Medicare Part D or MediCal but is not covered for those in rehab on Part A without Part D coverage. This means your Fall vaccination program should involve your pharmacy intermediary.
Now is the time to prepare for a successful Fall Vaccine program. Learn from Dr. Noah Marco (CALTCM RSV co-presenter) about facility implementation details.

Resources
CALTCM Learning Portal: https://caltcm.mclms.net/en/
https://www.healthinaging.org/sites/default/files/media/pdf/HIA-TipSheet-RSV-vaccine-Basic1-FINAL.pdf
https://www.healthinaging.org/sites/default/files/media/pdf/HIA-LearnMore-RSV-Vaccine-FINAL.pdf