The French Academy of Medicine recommends that vaccination against Respiratory Syncytial Virus (RSV) be reimbursed for elderly or frail individuals
31 March 2026
While considered a long time as a pediatric infection, respiratory syncytial virus (RSV) now also threats considerably the elderly.
RSV infection affects all age groups. In infants, it is the leading cause of bronchiolitis, whilst in older adults or those with compromised immune systems, it can lead to severe forms of the disease, particularly in the presence of comorbidities (cardiac, pulmonary). Intergenerational transmission is common, particularly from infants to older people within the household.
The French Academy of Medicine recommends that vaccination against Respiratory Syncytial Virus (RSV) be reimbursed for elderly or frail individuals
Its incidence is responsible for more than 8,000 deaths per year, 93% of which occur in people aged 65 and over (2). Among people over 75, its incidence in the Danish population is comparable to that of influenza (3).
The consequences are significant, both in the short and long term: the risk of admission to intensive care is four times higher and the risk of death three times higher compared with uninfected individuals. The average cost is high (€20,181 versus €8,085) (4). Furthermore, the risk of cardiovascular complications is similar to that observed with influenza or SARS-CoV-2 (5–7). Beyond the acute phase, RSV infection can also exacerbate or precipitate a loss of independence and an increase in functional impairments in older people.
Vaccination against RSV reduces A&E visits, hospitalizations and severe cases by 82–95% among people over 75, particularly in England (8) and the United States (9). Its effectiveness lasts for at least three years.
As early as 2023, the French Academy of Medicine recommended this vaccination for older people (10). Three vaccines have since been approved in the European Union: Arexvy (adjuvanted), Abccrysvo (non-adjuvanted) and mResvia (mRNA vaccine).
Since June 2024, the HAS has recommended vaccination for people aged 75 and over. These vaccines received a favorable opinion for reimbursement on 23 October 2024.
However, they are still not covered by the National Health Insurance Scheme, due to a lack of agreement on their price between the pharmaceutical companies and the Economic Committee for Health Products. As a result, vaccination coverage among older people remains very low, well below that for influenza or Covid.
In context of this situation, the French Academy of Medicine recommends that the public authorities:
1- Inform the public about the frequency and severity of RSV infection among elderly and frail people;
2.- Better document its prevalence in France;
3-.Enable, through an agreement with the relevant laboratories, the reimbursement of the vaccine for people over the age of 75 and immunocompromised individuals, particularly transplanted patients.
The delay in implementing these measures poses a major public health challenge.
References
– Nuttens C et al. Estimation of general practitioner visits, hospitalizations and deaths attributable to Respiratory Syncytial Virus and Influenza Virus, and costs associated with hospitalizations, in older adults in France from 2010 to 2020 (2025). Open Forum Infectious Diseases. Volume 12, Issue 12, ofaf735. https://doi.org/10.1093/ofid/ofaf735, doi: 10.1093/ofid/ofaf735. https://pubmed.ncbi.nlm.nih.gov/41409224/
– Fleming DM et al. Modelling estimates of the burden of Respiratory Syncytial virus infection in adults and the elderly in the United Kingdom (2015). BMC Infect Dis. Oct 23;15:443. doi: 10.1186/s12879-015-1218-z. https://pubmed.ncbi.nlm.nih.gov/26497750/
– Fonseca MJ et al. Incidence of respiratory syncytial virus and influenza: A Danish nationwide cohort study (2016). Human Vaccin Immunother. Dec;22(1):2638638. doi: 10.1080/21645515.2026.2638638. https://pubmed.ncbi.nlm.nih.gov/41860582/
– Fonseca MJ et al. Burden of respiratory syncytial virus and influenza in adults A Danish nationwide cohort study 2026). Clin Microbiol Infect. Mar 14:S1198-743X(26)00125-4. doi: 10.1016/j.cmi.2026.03.011. https://pubmed.ncbi.nlm.nih.gov/41839420/
– Hviid et al. Cardiovascular Events 1 Year After Respiratory Syncytial Virus Infection in Adults (2025). JAMA Netw Open Dec 1;8(12):e2547618. doi: 10.1001/jamanetworkopen.2025.47618. https://pubmed.ncbi.nlm.nih.gov/41359332/
– Liang C et al. Risk of Cardiorespiratory Events Following Respiratory Syncytial Virus-Related Hospitalization (2026). JAMA Netw Open Feb 2;9(2):e2556767. doi: 10.1001/jamanetworkopen.2025.56767. https://pubmed.ncbi.nlm.nih.gov/41359332/
– Montiel J et al. The risk of cardiac disease events after respiratory syncytial virus disease: a systematic literature review and meta-analysis (2026). Eur Respir Rev. Jan 28;35(179):250160. doi: 10.1183/16000617.0160-2025. https://pubmed.ncbi.nlm.nih.gov/41605540/
– Symes R et al. Vaccine effectiveness of a bivalent respiratory syncytial virus (RSV) pre-F vaccine against RSV-associated hospital admission among adults aged 75-79 years in England: a multicentre, test-negative, case-control study (2026). Lancet Infect Dis Mar;26(3):229-238. doi: 10.1016/S1473-3099(25)00546-8. Epub 2025 Oct 27. https://pubmed.ncbi.nlm.nih.gov/41167207/
– Tartof SY et al Estimated Vaccine Effectiveness for Respiratory Syncytial Virus-Related Acute Respiratory Illness in Older Adults: Findings From the First Postlicensure Season (2026). Clin Infect Dis. Feb 25;82(2):e361-e370. doi: 10.1093/cid/ciaf496. https://pubmed.ncbi.nlm.nih.gov/41117531/
– Buisson Y, Bégué P, Michel JP au nom d’un groupe de travail de la Commission VI. Rapport 23-25. Vaccination des seniors. Bull. Acad. Natl Med. 208 (2024) 131—141. https://www.academie-medecine.fr/vaccination-des-seniors/
