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In the Journals: Two RSV Vaccines for Elderly Adults

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In the Journals: Two RSV Vaccines for Elderly Adults
March 22, 2023

Respiratory syncytial virus (RSV) kills between 6,000 and 10,000 elderly adults every year. For this reason, an effective RSV vaccine for older adults would be of tremendous value.

In the February 16, 2023, issue of the New England Journal of Medicine, two different RSV vaccines were evaluated.

The first vaccine, made by GlaxoSmithKline, evaluated the efficacy of a purified RSV fusion protein locked in the prefusion state (RSVPreF3 OA) and adjuvanted with ASO1e, which is the same adjuvant used in Shingrix (monophosphorylated lipid A plus saponin QS21) (Papi A, Ison MG, Langley JM, et al. Respiratory syncytial virus prefusion F protein vaccine in older adults. N Engl J Med. 2023, Feb 16;388(7):595-608). About 25,000 participants over 60 years of age were enrolled in a prospective, placebo-controlled trial and followed for about seven months. Efficacy against lower respiratory tract disease was 82.6%. Efficacy against severe lower respiratory tract disease was 94.1%.

The second vaccine, made by Janssen, evaluated the efficacy of a vectored virus vaccine using adenovirus type 26 containing the prefusion F protein (Falsey AR, Williams K, Gymnopoulou E, et al. Efficacy and safety of an Ad26.RSV.preF-RSV preF protein vaccine in older adults. N Engl J Med. 2023, Feb 16;388(7):609-620). This is the same vector that Janssen used to make a SARS-CoV-2 virus vaccine. About 5,800 participants over 65 years of age were enrolled in a prospective, placebo-controlled trial. Efficacy against lower respiratory tract disease was 80%.

The FDA Vaccine Advisory Committee met on February 28, 2023, and March 1, 2023, and voted to recommend both vaccines.

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