The importance of vaccinating against the Respiratory Syncytial Virus (RSV) in England

Tuesday, September 24, 2024

In this article, Dr Wei Shen Lim, Consultant Respiratory Physician and Honorary Professor of Respiratory Medicine at Nottingham University Hospitals NHS Trust, and colleague Dr Rebecca Symes, Public Health Registrar working with UKHSA, discuss the importance of vaccination against Respiratory Syncytial Virus (RSV) in England. 

What do the rates of RSV look like in England, and what groups of people are most likely to be severely affected by it?

  • Respiratory Syncytial Virus (RSV) is a common cause of respiratory tract infections in adults and children.
  • Infection with RSV occurs predominantly in the winter, typically around December and usually results in a mild, self-limiting illness. 
  • However, in infant and older adults, infection with RSV can be very severe, resulting in GP attendances, hospital admissions and deaths.
One UK study estimated around 14,000 hospitalisations and just under 8,000 deaths in older adults were attributable to RSV during an average season.
  • Amongst adults, the persons at highest risk of severe illness from RSV are those of older age, particularly if living with other underlying health conditions  or frailty.
  • Severe RSV infection can present as pneumonia, acute bronchitis, or a worsening of existing underlying conditions such as COPD or heart disease.
  • One UK study estimated around 14,000 hospitalisations and just under 8,000 deaths in older adults were attributable to RSV during an average season. 
  • Preliminary results from a UK study conducted over a single season (2023/24) estimated the incidence of RSV hospitalisation in persons aged 65 year and over at about 64 per 100,000 persons with the highest incidence in those aged 80+ years (108 per 100,000). For comparison, the corresponding figures for flu admissions were 107 and 184 per 100,000 persons. 
  • Mortality at 90 days was higher for RSV (13%) than for flu (5%) in persons aged 75 – 79 years old hospitalised with these infections. 

Can you talk us through the vaccination programme in England?

The RSV vaccination programme for older adults in England was introduced from 1 September 2024. The programme aims to improve health outcomes for patients by reducing the risk of severe illness and complications caused by RSV.

All adults who turn 75 years old on or after 1 September 2024 will be eligible for the routine RSV vaccination programme and should be offered a single dose of the RSV vaccine.
  •  All adults who turn 75 years old on or after 1 September 2024 will be eligible for the routine RSV vaccination programme and should be offered a single dose of the RSV vaccine. 
  • There is also a one-off catch-up campaign for those already aged 75 to 79 years old on 1 September 2024.
  • Eligible adults will be invited to get their RSV vaccine by their GP Practice. 
  • The RSV vaccine is available all year round. 

How can our colleagues help to positively impact patient health outcomes through the promotion of the vaccine?

Health professionals are consistently viewed by the public as being trusted sources of advice in relation to vaccination. Many adults may not be aware of RSV as a cause of potentially severe respiratory infections. Respiratory professionals can help by providing information regarding RSV and explaining the rationale behind the RSV vaccination programme. This may be of particular relevant to persons living with chronic lung conditions. 

There is no specific antiviral therapy or treatment for RSV infection. Hence preventative measures such as vaccination are  an important  way to reduce the health impacts of RSV infection.  

Communication about the benefits of vaccination, including reduced risks of severe respiratory complications, is important. This can be done by integrating conversations about vaccination into routine clinical practice, such as during consultations or respiratory assessments. Resources to promote vaccination such as posters and leaflets are also available.

What does the surveillance programme for RSV look like, and why is this important?

The UK Health Security Agency (UKHSA) conducts surveillance of RSV activity across England, publishing information throughout the RSV season. The surveillance programme involves monitoring RSV infection rates, hospital admissions, and outcomes. Surveillance data are collected from various sources including laboratory reports, primary care, and secondary care. UKHSA’s Respiratory Virus Unit monitors RSV strains. 

A new hospital-based acute respiratory infection surveillance system (HARISS) was developed in 2023. One of the purposes of HARISS is to provide enhanced surveillance data on RSV activity and improved estimates of RSV vaccine effectiveness. These data are important to inform the shape of the RSV vaccination programme in future years, especially as more vaccine products become available.

Where can further resources on managing/treating RSV, and the RSV vaccination programme be found?

Respiratory professionals can access further information on the RSV vaccination programme from Respiratory syncytial virus (RSV) vaccination programme. Information includes guidance for health professionals and resources including leaflets and posters.