RSV vaccination linked to marked reduction in thromboembolic events in older adults

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RSV vaccination linked to marked reduction in thromboembolic events in older adults

Respiratory syncytial virus (RSV) vaccination provided substantial protection against RSV-associated thromboembolic complications in older adults during the same season as vaccination, according to a large US retrospective cohort study published in Emerging Infectious Diseases.

Ryan E. Wiegand, Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues evaluated community-dwelling fee-for-service Medicare beneficiaries aged ≥65 years between October 1, 2023 and March 30, 2024. The analysis included 15,558,386 beneficiaries, of whom 58% were women, 80% lived in urban areas, and 13% had immunocompromising conditions. 

RSV-associated thromboembolic events were defined as myocardial infarction, ischaemic stroke, or venous thromboembolism occurring from 7 days before to 30 days after an RSV diagnosis.

After adjusting for confounders, RSV vaccination demonstrated vaccine effectiveness (VE) of 79% (95% confidence interval [CI], 74%-83%) against RSV-associated thromboembolic events among all beneficiaries. Consistent protection was observed across major subgroups, with VE of 82% (95% CI, 77%-86%) in immunocompetent individuals and 69% (95% CI, 56%-78%) in immunocompromised patients. Protection was similar by age -- 75% (95% CI, 63%-83%) in adults aged 65-74 years and 80% (95% CI, 74%-84%) in those aged ≥75 years.

Effectiveness was stable over time, with VE of 80% at 14-59 days, 79% at 60-119 days, and 75% beyond 120 days after vaccination, suggesting minimal waning over the first 4 months. Comparable results were observed for both licensed products, with VE of 76% for Arexvy and 85% for Abrysvo. Sensitivity analyses extending follow-up and restricting to periods of high RSV circulation produced similar estimates.

By contrast, VE against all-cause thromboembolic events, regardless of RSV diagnosis, was lower at 21%.

“This study demonstrates the effectiveness of RSV vaccines against RSV-associated thromboembolic events, including myocardial infarction, ischaemic stroke, and venous thromboembolism,” the authors concluded. “Our findings are consistent with studies demonstrating that influenza and COVID-19 vaccines reduce the likelihood of thromboembolic events in adults.”

Source: Emerging Infectious Diseases