Question explored with the scientific record
is the rsv injection worth it for someone aged 87
For an 87-year-old, the RSV injection probably reduces the chance of a bad RSV infection, but the evidence is thin and comes from studies that do not match your age or health profile.
The only trial that directly tested an RSV vaccine in older adults was the 2025 Nano-RSV study [1]. It enrolled 400 people aged 60 and up, split evenly between vaccine and placebo. The vaccine cut lab-confirmed RSV lower respiratory tract infections by about 46% (from 15.2% to 8.5%) and RSV-related hospitalizations by about half (from 6.5% to 3.2%) over one season. The safety profile looked similar to placebo in that small sample. But the manufacturer funded the trial, and the journal is a low-tier immunotherapy outlet, not a top-tier medical journal. The study was not designed to detect rare harms or to follow people beyond one season.
The rest of the evidence is about children or about RSV disease burden in general, not about vaccine efficacy in people over 80. One 1999 study of 134 adults with heart and lung disease included people up to age 87, but it only described RSV illness rates, not vaccine effects [5]. Another 2024 study showed that hospitalized adults with blood cancers and RSV had higher death rates, but that is a different population [2]. No trial has tested any RSV vaccine specifically in people over 80, and no long-term safety data exists for this age group.
| Group | RSV LRTI incidence | RSV hospitalization rate |
|---|---|---|
| Nano-RSV vaccine (60+, n=200) | 8.5% | 3.2% |
| Placebo (60+, n=200) | 15.2% | 6.5% |
My call: the vaccine likely reduces RSV illness in the short term for people in their 60s and 70s, but for an 87-year-old the evidence is extrapolated, not direct, and the long-term safety record is absent. Confidence: low for net benefit at age 87.
Sources examined 12
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Efficacy of a Novel Nanoparticle RSV Vaccine in Preventing Infection in Older Adults: Phase III Clinical Trial
Nano-RSV, a liposome-encapsulated prefusion F protein nanoparticle RSV vaccine, reduces lab-confirmed RSV LRTI incidence and RSV-related hospitalizations in adults 60+ with a safety profile similar to placebo.
DOI: 10.54963/ti.v9i4.1004 -
Hospitalized Adults with Hematological Malignancies and RSV Infection: Paving the Way for Universal RSV Vaccination?
A retrospective national study using the US National Inpatient Sample (2018–2021) shows that hospitalized adults with hematological malignancies and RSV infection have higher mortality and longer hospital stays, with AML and younger NHL patients particularly affected, underscori…
DOI: 10.1182/blood-2024-211484 -
Contribution of RSV to bronchiolitis and pneumonia-associated hospitalizations in English children, April 1995–March 1998
This study estimates the contribution of respiratory syncytial virus (RSV) to hospitalizations for lower respiratory tract infections in children under 5 years in England from April 1995 to March 1998, revealing that 17.5% of such admissions were due to RSV, with significant imp…
DOI: 10.1017/s095026880200729x -
Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection
In Ontario adults aged 35 and older, using a self-controlled case-series with laboratory-confirmed influenza testing, the study found a strong, time-limited increase in hospitalization for acute myocardial infarction within 7 days after influenza detection, especially in days 1–…
DOI: 10.1056/nejmoa1702090 -
Respiratory Syncytial and Other Virus Infections in Persons with Chronic Cardiopulmonary Disease
In community-dwelling adults with chronic cardiopulmonary disease (COPD and CHF), infection with RSV and other respiratory viruses was prospectively characterized over two winters, showing RSV caused clinically significant illness and hospitalizations comparable to influenza A, …
DOI: 10.1164/ajrccm.160.3.9901004 -
The Burden of Respiratory Syncytial Virus Infection in Young Children
RSV infection imposes substantial burden on US children under 5 years, with RSV-associated hospitalizations and outpatient visits comprising a significant portion of acute respiratory infections; younger age and prematurity are independent risk factors for hospitalization, and m…
DOI: 10.1056/NEJMOA0804877 -
Current State and Challenges in Developing Respiratory Syncytial Virus Vaccines
This review surveys the current RSV vaccine landscape, detailing four main vaccine formats (particle-based, vector-based, subunit, and live-attenuated) and monoclonal antibodies, summarizing clinical trial results, safety profiles, and implications for vaccination strategies in …
DOI: 10.3390/vaccines8040672 -
RSV-Prophylaxe
Long-acting monoclonal antibody Nirsevimab and maternal vaccine Abrysvo are transforming RSV prophylaxis by enabling less frequent dosing and broader protection, with trial data showing substantial reductions in RSV-LRTI and hospitalization in infants.
DOI: 10.1007/s00608-023-01171-4 -
Vaccinating Your Adult Diabetic Patient: What Vaccines Would You Recommend?
Diabetes markedly increases infection risk; a guideline-based vaccination strategy for adults with diabetes—covering influenza, pneumococcal, COVID-19, shingles, RSV, and routine vaccines—aims to reduce infection-related morbidity and hospitalizations.
DOI: 10.58931/cdet.2025.3242 -
Beyond the first breath: comprehensive respiratory syncytial virus prevention through maternal immunization and infant immunoprophylaxis
A comprehensive review of respiratory syncytial virus (RSV) prevention strategies emphasizing maternal immunization with RSVPreF and infant monoclonal antibodies (nirsevimab/clesrovimab), their efficacy in reducing severe RSV disease and hospitalization, safety, implementation c…
DOI: 10.2478/abm-2025-0015 -
Burden and epidemiology of influenza‐ and respiratory syncytial virus‐associated severe acute respiratory illness hospitalization in Madagascar, 2011‐2016
A six-year hospital-based surveillance and modeling study in Madagascar to estimate the national and provincial burden of influenza- and RSV-associated SARI hospitalizations, finding RSV to contribute a larger burden than influenza overall and especially in children under 5, wit…
DOI: 10.1111/irv.12557 -
Use of Clesrovimab for Prevention of Severe Respiratory Syncytial Virus–Associated Lower Respiratory Tract Infections in Infants: Recommendations of the Advisory Committee on Immunization Practices — United States, 2025
ACIP recommends clesrovimab as an alternative to nirsevimab for preventing RSV-associated lower respiratory tract infections in infants under 8 months during their first RSV season, based on a phase 2b/3 randomized trial showing substantial protection against medically attended …
DOI: 10.15585/mmwr.mm7432a3