Addressing the Alarming Low Rates of RSV Vaccination in Vulnerable Groups

Despite recent advancements in respiratory syncytial virus (RSV) immunization, vaccination rates among pregnant women and older adults remain critically low, raising concerns among health experts and policymakers. According to a systematic review published in July 2025, which analyzed data from over 1.38 million individuals across several European countries and the United States, the uptake of RSV vaccines varied significantly, with only 30.5% of pregnant women receiving the vaccine and an average of 18.2% for older adults aged 60 and above.

RSV is a leading cause of lower respiratory tract infections in infants and young children, with the most severe cases typically occurring in those under six months. Recent clinical developments include the approval of two vaccines—Arexvy and Abrysvo—and monoclonal antibodies such as nirsevimab and cleesrovimab, designed to protect vulnerable populations. The vaccines have shown strong efficacy in clinical trials; however, their real-world application raises questions about public health strategies and outreach efforts.

Among the countries reviewed in the systematic review, Spain exhibited the highest uptake of nirsevimab at 90.1%, while the U.S. lagged significantly behind with only 51.2% of eligible infants vaccinated during the 2023-2024 RSV season. This disparity highlights the need for targeted initiatives to increase vaccination rates, particularly in communities with historically low uptake, such as among Black and Hispanic populations.

Dr. Emily Carter, an epidemiologist at Johns Hopkins University, states, "The data clearly shows that we have effective tools to combat RSV, but systemic barriers prevent vulnerable populations from accessing these life-saving vaccines." These barriers include lack of insurance coverage and socioeconomic factors that disproportionately affect certain demographic groups.

The World Health Organization has emphasized the global urgency for implementing immunization programs aimed at preventing severe RSV disease in infants and young children, especially in low- and middle-income countries where the disease burden is particularly high. In 2019 alone, approximately 100,000 children under five died from RSV-related infections, with a significant number of deaths occurring in infants less than five months old.

In response to the alarming vaccination rates, the German Standing Committee on Vaccination has recommended that infants born during specific months receive RSV prophylaxis before their first RSV season. However, experts argue that coordinated national and clinical efforts are necessary to ensure equitable access to RSV vaccinations across all demographics.

The potential long-term implications of low vaccination rates could lead to increased hospitalizations and fatalities among vulnerable populations, stressing the importance of immediate action. As the healthcare landscape continues to evolve, public health authorities must prioritize RSV vaccination initiatives to mitigate the consequences of this pervasive virus. The upcoming flu season could serve as a critical opportunity for health organizations to reinforce their vaccination outreach strategies, ensuring that all high-risk populations receive the protections they need against RSV.