RESPIRATORY syncytial virus (RSV) in older adults remains underrecognized, with policy gaps limiting surveillance, vaccination, and prevention across Europe.
RSV is widely associated with pediatric disease, but this review highlights its growing relevance in aging populations and the pressure it places on health systems. As demographic change increases the proportion of older adults, the authors argue that RSV in older adults should be treated as a major public health priority. Despite the arrival of new RSV vaccines, adult immunization policy remains inconsistent, and preparedness varies considerably across countries.
The study assessed RSV surveillance, vaccination strategies, and capacity building across eight European countries using a structured questionnaire completed by 15 of 19 experts, representing a response rate of 79%. The findings point to substantial variation in how health systems identify, monitor, and respond to RSV in older adults.
Surveillance and Vaccination Gaps
A central finding was the fragmented nature of RSV surveillance. In several settings, surveillance systems were either incomplete or not sufficiently tailored to older adults, limiting the ability to measure disease burden accurately and guide vaccination policy. The authors also identified limited or absent vaccine recommendations for older adults, suggesting that scientific progress has not yet translated into consistent public health action.
In addition, the review found inadequate age specific monitoring, which may obscure the true burden of severe RSV disease in later life. Gaps in professional education and public communication were also evident, raising concerns about whether healthcare professionals and patients have the information needed to support prevention efforts and informed vaccine uptake.
Public Health Policy Implications
The authors propose a policy roadmap focused on three areas: stronger surveillance infrastructure, more equitable access to RSV vaccination, and improved training and awareness for healthcare professionals and the public. Together, these measures are intended to support a life course approach to immunization and strengthen prevention-oriented care.
For clinicians and public health stakeholders, the message is clear. RSV in older adults is no longer a peripheral issue. Better surveillance, clearer vaccine policy, and stronger communication strategies will be essential to reduce severe disease and build more resilient health systems for aging populations.
Reference
D’Ambrosio F et al. Addressing RSV infection in older adults: implications for public health policy. Expert Rev Vaccines. 2026:2644348.
