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Two vaccines are currently on the Belgian market for vaccination against RSV in older adults: Abrysvo® and Arexvy®.
Both vaccines show good efficacy in the prevention of RSV associated lower-respiratory tract infection in the setting of clinical trials.
Recent real-world data show that vaccine effectiveness against hospitalization or emergency department visits aligns closely with clinical trial efficacy estimates for lower respiratory tract disease. Moreover, protection was demonstrated in a population with underlying conditions and immunocompromised patients, who are under or not represented in clinical trials.
Risk factors for severe RSV disease include:
– Immunodeficient patients
– Chronic Kidney Disease
– Severe obesity (BMI ≥ 40)
– Chronic Respiratory Diseases (COPD, asthma, bronchiectasis, interstitial lung diseases, chronic respiratory failure)
– Current smoker
– Chronic Heart Failure – Coronary Artery Disease
– Diabetes
– Stroke

Considering the high morbidity and mortality associated with RSV infection among patients with known risk factors and the lack of effective anti-viral therapy, the Superior Health Council recommends vaccination against RSV for:
– At risk persons over 60 years old with at least one risk factor for developing severe RSV disease (listed above), immunodeficient patients (including patients with solid cancer or haematologic malignancy, use of immunosuppressive medications, solid organ transplantation, allogenic HCT) and people living in nursing homes;
– All persons over 75 years old, especially those with a risk factor listed above or frail/pre-frail status.
The recommended dose is one single injection intramuscularly with one of the 2 vaccines available (Arexvy ® or Abrysvo ®).

Considering the pre-COVID seasonality of RSV, September/October are the preferred months to be vaccinated although vaccination may be performed year round.

Meer infos: Superior Health Council. Vaccination against RSV for older adults. Brussels: SHC; 2024. Report 9837.