Research Develops Key Points to Address RSV Vaccine Hesitancy in Older Adults


Addressing complacency, confidence, and convenience are all crucial to increasing vaccine uptake.

Respiratory syncytial virus (RSV) causes lower respiratory tract disease (LRTD), especially in adults older than 60. The FDA has approved Arexvy (adjuvanted RSV vaccine; GSK) for adults 60 years and older, as well as Abrysvo (RSV vaccine; Pfizer) for adults 60 years and older and pregnant individuals at 32 to 36 weeks’ gestation.

RSV vaccine vial with syringe - Respiratory syncytial virus shot

Image Credit: MargJohnsonVA |

In community settings, RSV vaccine hesitancy is a concern. Questions flood phone lines at many pharmacies. Pharmacy staff may field questions like

  1. “My doctor told me to get the RSV vaccine. Is it safe and effective?”
  2. “Do I need the RSV vaccine annually?”
  3. “Is the vaccine covered by my insurance? How much is the copay?”

Older adults have pressing questions regarding vaccines’ efficacy and safety, and perceived risks of vaccines are often greater than proven risks. Furthermore, many individuals do not know that their insurance covers the RSV vaccines.

The Canadian Pharmacists Journal has published a research article that addresses RSV vaccine hesitancy in its January/February 2024 issue. The researcher adapted the “3C Model of Vaccine Hesitancy” from a report by the World Health Organization (WHO) to address vaccine concerns. The 3C Model is comprised of 3 components: complacency, confidence, and convenience. The WHO defines the terms as follows:

  1. Complacency exists when the perceived risks of vaccine-preventable disease are low, and people consider vaccination unnecessary.
  2. Confidence is defined as trust in the vaccine effectiveness and safety, the system that delivers them, and policymakers’ motivations when deciding on the needed vaccines.
  3. Convenience is defined as the extent to which the ability to understand, the appeal of immunization services, affordability and willingness-to-pay, geographic accessibility, and physical availability affect uptake.

The researcher applied the 3C Model to the current RSV situation, generating key points to equip pharmacists. Using the key points, pharmacists and other health care professionals can combat RSV vaccine hesitancy or ease the general public’s concerns. Selected key points from the research article can be simplified as follows:

About the Author

Marvin Y. Fong, PharmD, CDE, is a staff pharmacist at Beeman's Highland Pharmacy in San Bernardino, California.

  1. To combat complacency, pharmacists should educate patients that RSV contributes to many hospitalizations and deaths each year. The lengths of stay, rates of intensive care use, and mortality are similar for RSV and influenza A.
  2. To boost confidence, pharmacists can point out that clinical trials have demonstrated that adverse effect profiles are similar in RSV compared to other vaccines. Current RSV vaccines offer more effective immune response than the vaccine trialed in the 1960s.
  3. To improve convenience, point out that the adjuvanted RSV vaccine offers a duration of protection for at least 2 seasons with a single dose. Health care professionals can also administer the adjuvanted RSV vaccine with other vaccines at the same visit.

Arexvy and Abrysvo are available at community pharmacies in the United States. However, the researcher’s discussion does not cover Abrysvo. At the time of publication, Abrysvo was still seeking indications in Canada. Pharmacists can use the aforementioned key points to address RSV vaccine hesitancy in discussions with patients and help dispel any myths surrounding the use of RSV vaccines.


Houle SKD, Andrew MK. RSV vaccination in older adults: Addressing vaccine hesitancy using the 3C model. Can Pharm J (Ott). 2023;157(1):39-44. Published 2023 Nov 24. doi:10.1177/17151635231210879

Related Videos
Image credit:  Gorodenkoff |
Carrie Koenigsfeld, PharmD, FAPhA, an expert on RSV vaccination
Carrie Koenigsfeld, PharmD, FAPhA, an expert on RSV vaccination
Sun Screen, Photosensitivity, Pharmacy | Image Credit: sosiukin -
Catalyst Trial, Diabetes, Hypertension | Image Credit: grinny -
1 KOL is featured in this series.
1 KOL is featured in this series.
Ashley Pugh, PharmD, and Lauren Angelo, PharmD, MBA
Various healthy foods -- Image credit: New Africa |
© 2024 MJH Life Sciences

All rights reserved.