Killikelly April, Siu Winnie, Abrams Elissa M, Brousseau Nicholas
Public Health Agency of Canada, Centre for Immunization and Respiratory Infectious Diseases, Ottawa, ON.
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON.
Can Commun Dis Rep. 2025 Aug 28;51(8):292-296. doi: 10.14745/ccdr.v51i08a01. eCollection 2025 Aug.
Respiratory syncytial virus (RSV) is a common respiratory virus. In addition to infants, older adults are at higher risk of severe outcomes due to RSV, particularly advanced-age older adults and those with chronic medical conditions. The authorization of three vaccines, one for adults 50 years of age and older (Arexvy) and two for adults 60 years of age and older (Abrysvo and mRESVIA), offers the opportunity to protect older Canadians from RSV disease. This article summarizes guidance from the National Advisory Committee on Immunization (NACI) on the prevention of RSV in older adults.
NACI established key policy questions and performed an evidence review and synthesis for three new vaccines. In consideration of the burden of illness to be prevented, safety and efficacy of the new immunizing products, economic evidence and ethics, equity, feasibility and acceptability considerations, NACI made evidence-based recommendations.
The three RSV vaccines may provide similar reductions in hospitalizations associated with RSV and medically attended RSV respiratory tract infection for adults 60 years of age and older. However, evidence is limited for other outcomes. These vaccines were well-tolerated in clinical studies, with an acceptable safety profile among older adults. The duration of protection of the RSV vaccine is not yet known, and it is unclear if the protection offered by vaccination can be boosted by subsequent doses of vaccine.
Based on available evidence, NACI recommends RSV immunization programs for adults 75 years of age and older, particularly for older adults with chronic health conditions who are at increased risk of severe RSV disease. NACI also recommends RSV immunization programs for adults 60 years of age and older who are residents of nursing homes and other chronic care facilities. NACI recommends that receiving an RSV vaccine may be considered as an individual decision by adults 50 to 74 years of age, in consultation with their healthcare provider.
呼吸道合胞病毒（RSV）是一种常见的呼吸道病毒。除婴儿外，老年人因RSV感染出现严重后果的风险更高，尤其是高龄老年人以及患有慢性疾病的老年人。三种疫苗已获批准，一种用于50岁及以上成年人（Arexvy），两种用于60岁及以上成年人（Abrysvo和mRESVIA），这为保护加拿大老年人免受RSV疾病侵害提供了机会。本文总结了国家免疫咨询委员会（NACI）关于预防老年人RSV感染的指导意见。
NACI确定了关键政策问题，并对三种新疫苗进行了证据审查和综合分析。考虑到要预防的疾病负担、新免疫产品的安全性和有效性、经济证据以及伦理、公平性、可行性和可接受性等因素，NACI提出了基于证据的建议。
三种RSV疫苗可能对60岁及以上成年人因RSV感染导致的住院治疗以及接受医疗护理的RSV呼吸道感染有相似的降低作用。然而，其他结果的证据有限。这些疫苗在临床研究中耐受性良好，在老年人中具有可接受的安全性。RSV疫苗的保护持续时间尚不清楚，也不清楚后续剂量的疫苗是否能增强接种疫苗所提供的保护。
基于现有证据，NACI建议为75岁及以上成年人开展RSV免疫计划，特别是针对患有慢性健康状况且严重RSV疾病风险增加的老年人。NACI还建议为养老院和其他长期护理机构的60岁及以上成年人开展RSV免疫计划。NACI建议50至74岁成年人可在与医疗服务提供者协商后，将接种RSV疫苗视为个人决定。
