Protecting Older Adults from Severe RSV: Key Challenges and the Importance of Prevention

In an interview with Pharmacy Times®, Katrin Burkart, PhD, assistant professor of health metrics sciences at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, highlights that respiratory syncytial virus (RSV) hospitalizations in older adults are often underdiagnosed due to low testing sensitivity and limited awareness. She emphasizes that treatment options are mostly supportive, making prevention through good hygiene and vaccination essential. Pharmacists play a crucial role in educating high-risk individuals about RSV risks and encouraging vaccination to reduce severe illness.

Pharmacy Times: What are the key challenges in managing the high burden of RSV hospitalizations in older adults, and what broader strategies are needed to address them?

Katrin Burkart, PhD: The key challenges in managing RSV-related hospitalizations are low awareness and the frequent underdiagnosis of the RSV virus. RSV is not routinely tested, and even when it is tested, the sensitivity of global diagnostic tools is often low. This can lead to a high rate of false negatives, particularly when testing occurs later in the disease course, as viral load tends to decline over time. As a result, RSV is often overlooked as a contributing agent to respiratory and especially cardiorespiratory disease. Another key challenge is that even if RSV is diagnosed, treatment options are limited. RSV treatment mostly consists of supportive care; therefore, prevention is key for RSV.

Pharmacy Times: Given the high hospitalization rates, what are the critical considerations for identifying and protecting older adults at high risk for severe RSV infection?

Burkart: Given the limited treatment options once RSV is contracted, prevention becomes especially critical. Like with other respiratory viruses, key prevention strategies include good hygiene practices such as frequent handwashing, wearing masks during high transmission periods, and avoiding crowded indoor settings. One of the most effective tools we now have is the RSV vaccine. The CDC currently recommends vaccination for all adults aged 75 and older, as well as for adults aged 60 to 74 who have an underlying health condition, such as a heart condition. Identifying these high-risk individuals and ensuring they are informed about vaccinations is a vital step in reducing the overall burden of RSV.

Pharmacy Times: What proactive steps can pharmacists take to identify and protect older adults at high risk for severe RSV?

Burkart: Pharmacists play a key role in educating individuals and the community about the risk of RSV. Many people are aware of RSV in the context of infants and young children, but far fewer realize that it can also cause serious illness in older adults. Pharmacists can help close that gap by informing patients about the risk and available prevention strategies, including discussing the RSV vaccine, which has been proven to be highly effective.