#2-39E. Does the RSVpreF Vaccine Offer Cardiorespiratory Protection in Older Adults? (JAMA, 2025)

Considering the established link between respiratory syncytial virus (RSV) infection and elevated cardiovascular risk in older adults, clinicians frequently ask whether RSV immunization offers protection beyond preventing pulmonary disease. This prespecified secondary analysis of the pragmatic DAN-RSV trial, involving over 131,000 adults aged 60 or older, investigated the effectiveness of the bivalent RSV prefusion F protein (RSVpreF) vaccine against cardiorespiratory and cardiovascular hospitalizations. The most critical finding is the significant 9.9% reduction in all-cause cardiorespiratory hospitalization observed in the RSVpreF group compared to the control group. This suggests potential downstream cardiorespiratory benefits of immunization, although the effect on isolated cardiovascular events was statistically nonsignificant. However, it is essential to critically note that the trial's statistical analysis plan did not include separate power calculations for cardiovascular endpoints, meaning these results should be interpreted as hypothesis generating only. These data strengthen the rationale for broad RSV vaccination recommendations in older adults, especially those vulnerable to cardiovascular complications, as a strategy to reduce severe composite cardiorespiratory events in routine practice.

Citation: Lassen MCH, et al. Bivalent RSV Prefusion F Protein–Based Vaccine for Preventing Cardiovascular Hospitalizations in Older Adults. A Prespecified Analysis of the DAN-RSV Trial. JAMA. 2025. DOI: 10.1001/jama.2025.15405

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