To assess the relationship of preexisting medical conditions to age-specific RSV hospitalization incidence and severe outcomes, including ICU admission and mortality, in adults.
Key Findings:
Adults with CHF, CAD, COPD, and diabetes had significantly higher hospitalization rates for RSV, with incidence rate ratios indicating strong associations.
Mean annual RSV hospitalization incidence was 2.5-fold higher for Black adults aged 18-44 and 8-fold higher for those aged 45-64 compared to other races, highlighting racial disparities.
Hispanic adults had a 2-3-fold higher incidence of hospitalization across all age groups compared to non-Hispanics, indicating ethnic disparities.
COPD increased the risk of ICU admission or in-hospital mortality by 1.9-fold, emphasizing the severity of this condition.
Interpretation:
Preexisting medical conditions and racial/ethnic disparities significantly influence RSV hospitalization rates and outcomes, suggesting the need for tailored vaccine recommendations to address these disparities.
Limitations:
Initial vaccine recommendations did not include adults <60 years with high-risk conditions, potentially overlooking a vulnerable population.
Clinical trials had limited representation of older adults and those with underlying conditions, which may affect the generalizability of the findings.
Conclusion:
Future RSV vaccine guidelines should consider the impact of preexisting conditions and racial/ethnic differences in hospitalization rates, as these factors are critical for effective public health interventions.
