RSV Immunization Shows Cardiorespiratory Benefits in Adults Aged 60 and Older

Adults aged 60 years and older demonstrated lower all-cause cardiorespiratory hospitalization with the respiratory syncytial virus (RSV) prefusion F protein-based vaccine compared with individuals that did not receive a vaccine. The study authors, who published their findings in JAMA, noted that receiving an RSV vaccine might have benefits for the heart and lungs, but its effect on all-cause cardiovascular hospitalization was not statistically significant.^1,2

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RSV and Cardiovascular Risk

RSV is associated with greater cardiovascular risk, as older adults and individuals with chronic medical conditions face a higher risk of severe RSV and related cardiovascular complications. Individuals who are most vulnerable to RSV include all adults 75 years and older, adults aged 50 to 74 years with specific risk factors, and individuals with weakened immune systems or those living in nursing homes. Those with chronic medical conditions like lung disease, heart failure, coronary artery disease, kidney disorders, obesity, and certain neurologic conditions are also at an increased risk.³

Specifically, RSV is known to damage the heart muscle, causing inadequate blood supply to the heart, known as ischemia, and increasing the risk of irregular heartbeat, or atrial fibrillation. The virus can also worsen existing heart conditions—such as arrhythmias and heart failure—and is linked to a higher risk of heart attack or stroke, particularly within the first 3 days of infection.³

Effectiveness of Bivalent RSVpreF Vaccine for Cardiovascular Disease

One of the 3 approved RSV vaccines—RSVpreF (Abrysvo; Pfizer)—has been approved to prevent lower respiratory tract illness caused by RSV; however, prior to this publication, its effectiveness in preventing cardiovascular problems had not yet been studied. To investigate its effectiveness for patients at increased risk for cardiovascular diseases, researchers conducted a prespecified secondary analysis of the DAN-RSV trial, a pragmatic, open-label, individually randomized clinical trial conducted in Denmark during the 2024 to 2025 winter season.¹

A total of 131,276 adults aged 60 years and older were included in the study, and 65,642 were randomly assigned to receive RSVpreF, and 65,634 did not receive a vaccine. Cardiorespiratory hospitalizations were a prespecified secondary outcome in the study, while hospitalizations for cardiovascular diseases, including heart failure, heart attack, stroke, and atrial fibrillation, were exploratory outcomes. The effectiveness of the vaccine was measured by calculating 1- the incidence rate ratio, and these outcomes were assessed from 14 days after the scheduled study visit until May 31, 2025.¹

Among the total amount of participants included in the study, a majority were men with an average age of 69 years, with about 22% having preexisting cardiovascular disease. The results found that the incidence of all-cause cardiorespiratory hospitalization was significantly lower in the group that received the RSVpreF vaccine compared to the control group. Specifically, the vaccine was associated with an approximate 9.9% reduction in these hospitalizations, which was shown regardless of whether an individual had preexisting cardiovascular disease.^1,2

However, the study did not find a statistically significant reduction in all-cause cardiovascular hospitalizations and did not show a significant difference in rates of stroke, heart attack, heart failure hospitalization, or atrial fibrillation between the vaccinated and control groups.^1,2

“The findings suggest potential downstream cardiorespiratory benefits of RSV immunization. The results support broader consideration of RSV vaccination in older adults, including among those with cardiovascular disease, as part of a strategy to reduce severe cardiorespiratory complications,” the authors wrote in the study.¹

REFERENCES

1. Lassen MCH, Johansen ND, Christensen SH, et al. Bivalent RSV Prefusion F Protein–Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults: A Prespecified Analysis of the DAN-RSV Trial. JAMA. Published online August 30, 2025. doi:10.1001/jama.2025.15405

2. Bivalent RSV prefusion F protein–based vaccine for preventing cardiovascular hospitalizations in older adults. EurekAlert! News release. August 30, 2025. Accessed September 7, 2025. https://www.eurekalert.org/news-releases/1096339

3. RSV and Heart Health. American Heart Association. News release. Updated July 30, 2025. Accessed September 2, 2025. https://www.heart.org/en/health-topics/rsv