RSV vaccine: evidence shows it works for the over-80s

The Respiratory Syncytial Virus (RSV) vaccine is currently denied to those aged over 80 in the UK, but new evidence shows that it is effective for them too. 

A study of RSV vaccine effectiveness among US veterans (which included the over-80s) published in the Lancet Infectious Diseases journal has found that the vaccine reduced hospitalisations associated with RSV by 80.3% and was 78.1% effective against documented RSV infection. And in the over-80s, the vaccine efficiency rate against RSV infection was 72%.

"This all adds more weight to the case for extending eligibility for the jab to that age group," says Dr Hamid Merchant, head of bioscience at the University of East London and editor of the  British Journal of Pharmacy.

"I think the RSV vaccine should be offered to those 80 and over now – the evidence is so strong that it will be very difficult to ignore it."

The American study looked at the health records of more than 146,000 people over 60, whose median age was 75.9. Almost a quarter were over 80, said Dr Merchant.

Why isn’t the RSV vaccine offered to those aged 80 and above? 

The RSV vaccine was offered to 75 to 79 year olds for the first time in the UK last autumn.

The reasons for RSV vaccine not offered to the over-80s in the programme – as explained by the Joint Committee on Vaccination and Immunisation (JCVI) – were lack of evidence of its effectiveness and low numbers of over-80s in the drug trials.

Although in most cases RSV will cause no more than a cold, sore throat or cough, in the vulnerable it can cause severe lung infections and can lead to life-threatening pneumonia. It results in 4,000 deaths of over 75 year olds each winter. 

The decision also provoked an angry response from Saga readers, many of whom questioned why the most vulnerable were not offered protection. 

Those aged 80 and over who wanted the vaccine have since only been able to get it privately at a cost of £245 per single dose. 

Len Parsons, 80, a retired telecoms manager who lives with his wife Christine, 81, in Rayleigh, Essex, was one of the readers who initially contacted us to express outrage at the situation. We’ve caught up with him again, and he explains he was so incensed he wrote to his local MP following our article.

"Basically I don’t want to die," he says.

"If there’s a vaccine available that can protect Christine and me against this virus I’d like to have it as soon as possible." 

"I’m lucky in that I’m reasonably healthy, but my wife has a number of chronic illnesses and is more vulnerable. I don’t see why the most vulnerable have been excluded, it doesn’t make sense – it’s absolutely crazy."

What will happen now?

Dr Merchant says this new data from America was precisely the kind of evidence the JCVI was looking for.

He says: "The committee met in February to review their position on RSV because they promised they would do this as new evidence emerged. Initial indications from meeting proceedings are that they were supportive of extending the RSV vaccination programme to the over-80s."

Dr Merchant points out that the RSV vaccine from Pfizer had been licensed by the Medicines and Healthcare Regulatory Agency (MHRA) for use in the over-60s with no upper age limit. 

What’s been the impact of the RSV vaccine on the 75 to 79 age group so far? 

A study published in April in The Lancet that measured the impact of the new RSV vaccination programme showed that the predicted RSV-associated hospital admissions in those aged 75 to 79 had seen a 30% reduction (this was with vaccine coverage rate of 41.8%). 

Dr Merchant believes the same sort of reductions could be anticipated in the over-80s if they were given the RSV vaccine. 

What is the government saying about RSV vaccinations? 

A Department of Health and Social Care spokesman told Saga Magazine: "We understand the frustration and concern of those over 80 who want an RSV vaccine. The government makes decisions on vaccine eligibility based on expert clinical advice from the independent JCVI. 

"The JCVI has advised there is less certainty about how effective the RSV vaccine is in people aged over 80."

The spokesman confirmed that during the JCVI’s main committee meeting on 5 February 2025, the committee said it planned further discussions on potential advice towards extending the programme to those over 80 years old.

"The JCVI will continue to keep the evidence under review and may provide further advice regarding future immunisation programmes in due course."

Could unused RSV vaccine be given to the over-80s who want it now? 

Uptake for the current RSV vaccination programme for those aged 75 to 79 has achieved a cumulative coverage rate of 60.3% according to government figures published in April.

Dr Merchant says there is a potential risk that vaccine supplies bought for the 75- to 79-year-olds could be wasted and argues that the RSV vaccine programme should be opened up to those aged 80 and over without further delay. 

"We have the data now so I don’t see any reason why we should delay any further," says Dr Merchant.

"There are ethical implications of not offering protection to those who are most vulnerable to adverse outcomes from RSV."

"Offering vaccines to under-80s for free on the NHS and asking over-80s to wait or have it privately at significant cost is against the ethos of the NHS."

Len agrees. "It would be a great shame if the vaccine that’s already been bought goes to waste when there are people 80 and over who would sign up for it," he says. "I certainly would."