RSV poses greater risk than flu for older adults, expert warns

An expert recently recommended vaccination against respiratory syncytial virus (RSV) for people aged 60 and older, as well as for those with certain underlying medical conditions.

RSV is an acute respiratory infection classified as a legal Category 4 infectious disease, alongside influenza and Covid-19. Like other respiratory illnesses, its symptoms include a runny nose, sore throat, cough, and phlegm. In high-risk individuals, it can lead to complications such as pneumonia, and in severe cases, may result in hospitalization or death. The risk of severe disease increases in people over the age of 60 and those with certain underlying medical conditions.

“The rate of hospitalization due to RSV infection increases significantly from the age of 60 and above, with about 65 per 100,000 population for those aged 60 to 64, 85 per 100,000 for those aged 65 to 69, 130 per 100,000 for those aged 70 and above, and 250 per 100,000 for those aged 80 and above,” Park Wan-beom, a professor of infectious diseases at Seoul National University Hospital, at a satellite symposium organized by GSK Korea to share the latest advances in RSV infection prevention at the 2025 Spring Meeting of the Korean Society for Antimicrobial Therapy and the Korean Society of Infectious Diseases on April 3-4 in Seoul.

“The risk of ICU admission and death is even higher than with influenza,” Park said. “In a study of individuals aged 60 and older, patients with RSV infection were 30 percent more likely to be admitted to the ICU and 30 percent more likely to die within one year of admission compared to those with influenza.”

RSV infections in individuals with underlying lung, heart, or other medical conditions further increase hospitalization rates and elevate the risk of aggravating pre-existing conditions.

“In patients aged 65 and older, RSV infection was detected in 11.4 percent of those hospitalized for COPD and 7.2 percent of those hospitalized for asthma,” Park said. “Additionally, patients with congestive heart failure were about 3.5 times more likely to be hospitalized due to RSV infection.”

Compared to influenza, patients with RSV infection were 70 percent more likely to experience an exacerbation of chronic lung disease and 50 percent more likely to have asthma. Given the high disease burden of RSV in older adults and those with underlying medical conditions, prevention is essential, Park added.

Given the high disease burden of RSV infections in older adults and individuals with underlying medical conditions, proactive prevention is increasingly important—especially as recent studies have confirmed the effectiveness of the RSV vaccine in high-risk populations, and international guidelines recommend vaccination for those aged 60 and older.

Also at the symposium, Park introduced GSK's RSV vaccine Arexvy.

Arexvy is the first RSV vaccine approved by the Korean Ministry of Food and Drug Safety, granted in December last year, for the prevention of lower respiratory tract disease (LRTD) caused by RSV in adults aged 60 and older.

The AReSVi-006 clinical study in adults aged 60 and older showed that a single dose of Arexvy provided 82.6 percent protection against RSV-related lower respiratory tract disease (RSV-LRTD) and 94.1 percent protection against severe RSV-LRTD during the first RSV season.

During the same period, consistently high levels of protection were observed in patients with underlying medical conditions—94.6 percent protection against RSV-LRTD in those with at least one underlying condition, and 92 percent in those with two or more.

In the second RSV season, Arexvy continued to be effective in preventing RSV-LRTD, with 67.2 percent prevention of RSV-LRTD and 78.8 percent prevention of severe RSV-LRTD. 

In a real-world study conducted in the U.S. during the 2023–2024 season, Arexvy demonstrated 83 percent vaccine efficacy against RSV-related inpatient hospitalizations and 77 percent efficacy against RSV-related emergency department visits in adults aged 60 and older, confirming its high level of protection in real-world clinical settings.

“RSV infection poses a significant disease burden for adults aged 60 and older, as well as those with underlying medical conditions, and with no specific treatment available, prevention is paramount,” said Kwon Hyun-ji, Head of GSK Korea’s Vaccines Business Unit. “With the upcoming official launch of Arexvy—the world’s first RSV vaccine—in Korea, we are committed to raising awareness about RSV and its prevention among immunocompromised older adults. We aim to establish a strong front against RSV in high-risk groups through vaccination.”