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New RSV Vaccines: Early Results Point to Need for Targeted Outreach

In 2023, for the first time ever, vaccines for the respiratory syncytial virus (RSV) became available, offering protection against an infection that causes tens of thousands of hospitalizations and deaths among older adults every year. Two RSV vaccines were approved by the Food & Drug Administration (FDA) in May 2023 and are recommended by the Centers for Disease Control and Prevention (CDC) for adults 60 and older who have discussed it with their health care provider. 

Because RSV season begins in the fall and peaks in winter, we wanted to learn whether older adults were embracing the vaccine during this first season of availability. In November 2023, AARP fielded a survey to better understand the uptake of and attitudes toward the new RSV vaccines. Not only did we find interesting parallels between RSV vaccine uptake and other vaccines, but we see more clearly how tricky it will be to ensure the vaccine’s benefits reach all older adults who should be getting it.

Here are some highlights and takeaways:

RSV vaccination is happening — but not consistently. Close to one in 10 respondents aged 60 and older (11 percent) reported receiving an RSV vaccine.[1] As the graphic below shows, there are notable variations in early uptake of the new vaccine by demographic and socioeconomic characteristics. White respondents (13 percent) were nearly twice as likely as Black and Hispanic respondents (6 percent and 7 percent, respectively) to have been vaccinated against RSV. Additionally, adults 60 and older living in urban areas, those with a college education or more, and those with higher incomes were more likely to have gotten the vaccine.

Characteristics of Early Adopters of RSV Vaccines, November 2023

Source: NORC at the University of Chicago’s AmeriSpeak 50+ Omnibus probability-based sample for AARP, November 2023.

Awareness of the RSV vaccine is growing. Shortly after the CDC issued its RSV vaccine recommendation, awareness of the RSV vaccine was low among older adults. In July 2023 just over one-third (36 percent) of adults 60 and older reported having heard of the new vaccine. By November 2023, nearly three out of four adults 60 and older (74 percent) were aware of the vaccine.

Many respondents are unsure about the RSV vaccine. Among the most common reasons respondents gave for not getting vaccinated against RSV were that they didn’t need it (39 percent), their provider didn’t recommend it (28 percent), or they didn’t trust information about the vaccine (27 percent). Older adults living in non-metropolitan areas were much more likely than those living in more urban areas to think they didn’t need to get vaccinated against RSV (56 percent vs. 38 percent, respectively).

Among the unvaccinated, interest in getting an RSV vaccine is split. Nearly half (48 percent) of unvaccinated respondents 60 and older reported being "not at all likely” or “not very likely” to get vaccinated against RSV. This sentiment was higher among Black and Hispanic respondents as well as respondents with a high school education or less.

Similarities to early shingles vaccine uptake

While 11 percent uptake may not sound like a high share of people getting the RSV vaccine, it is an improvement over the early uptake of another vaccine recommended for older adults. Nearly two decades ago, a vaccine for shingles (herpes zoster) was added to the adult vaccine schedule. The CDC recommended the first vaccine for shingles, Zostavax, for use in adults 60 and older in 2008 and an updated vaccine, Shingrix, in 2017 for the prevention of shingles among adults 50 and older.

Initial uptake of the shingles vaccine was slow, with only 7 percent of adults 60 and older vaccinated against shingles by the end of 2008. But by 2021, shingles vaccination coverage had increased to 41 percent among this population.

In addition, there were similar demographic and socioeconomic characteristics among the early adopters of the RSV vaccine and the shingles vaccine. Findings from the November AARP survey and other research conducted after the shingles vaccine was first introduced show that older adults who got vaccinated early for either vaccine were more likely to be white adults, have a college education, and have a higher income than late adopters and non-adopters.

RSV outreach efforts

Although early RSV vaccine adoption is outpacing early adoption of the shingles vaccine, the characteristics of older adults who get a new vaccine when it first becomes available has remained the same. These similarities can help inform targeted outreach campaigns for older adults who are less likely to get vaccinated, as well as general outreach and information to help improve vaccine uptake for all patients.

[1] According to CDC data, 20 percent of adults 60 years and older received an RSV vaccine as of January 6, 2024.

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