Cochrane Database Syst Rev
RSV vaccines offer strong protection for older adults and infants, Cochrane review finds
Study details: This Cochrane systematic review evaluated 14 randomized trials involving over 100,000 participants across key populations: older adults, pregnant people, infants, children, and individuals of childbearing age. The goal was to assess the efficacy and safety of various RSV vaccine platforms.
Results: In older adults, RSV prefusion vaccines demonstrated high efficacy, reducing RSV-associated lower respiratory tract illness by 77% and acute respiratory illness by 67% (high-certainty evidence). In contrast, postfusion vaccines showed no meaningful benefit in this population, with vaccine efficacy (VE) estimates near zero (moderate-certainty evidence).
Maternal RSV F protein-based vaccination significantly reduced RSV burden in infants, lowering the risk of medically attended RSV illness by 54%, severe lower respiratory tract illness by 74%, and RSV-related hospitalization by 54% (all high-certainty evidence).
Data on the efficacy of RSV vaccines on women of childbearing age and on infants and children were more limited and produced reports of low confidence. The evidence was very uncertain regarding all‐cause medically attended acute respiratory illness with VE of 26% (95% confidence interval [CI], −0.01 to 0.46). Among women of childbearing age, the evidence was very uncertain regarding new RSV infections with VE of 50% (95% CI, 0.08 to 0.73).
Clinical impact: RSV prefusion vaccines offer high-certainty protection for older adults, while maternal immunization provides robust infant protection against severe RSV outcomes. These findings support targeted RSV vaccination strategies to reduce disease burden in vulnerable populations.
Source:
Saif-Ur-Rahman KM, et al. (2025, September 29). Cochrane Database Syst Rev. Efficacy and safety of respiratory syncytial virus vaccines. https://pubmed.ncbi.nlm.nih.gov/41016728/