Is a 62-year-old female with well-controlled Hypertension (high blood pressure), Gastroesophageal Reflux Disease (GERD), and Osteoarthritis, and a Body Mass Index (BMI) of 23 kg/m2, who is taking Amlodipine, Losartan, Pantoprazole, and Acetaminophen, a candidate for Respiratory Syncytial Virus (RSV) vaccination?

From the Guidelines

JB is at a lower risk of severe RSV disease than many patients her age, and use of the RSV vaccine should be discussed by the patient and her healthcare provider at her next clinic visit. While JB is 62 years old, which places her in the age group eligible for RSV vaccination (adults 60 and older), she appears to have well-controlled chronic conditions and maintains good overall health with regular exercise and a normal BMI 1. The ACIP recommends that adults aged 60 years and older may receive a single dose of RSV vaccine using shared clinical decision-making, rather than a universal recommendation for all older adults. This approach is appropriate for JB because she lacks additional risk factors for severe RSV disease beyond her age, such as multiple chronic conditions, frailty, or immunocompromise 1. Her hypertension is well-controlled, and her other conditions (GERD and osteoarthritis) are not typically associated with increased risk of severe respiratory infections. Some key points to consider in the decision-making process include:

• JB's age and overall health status
• The presence or absence of risk factors for severe RSV disease, such as chronic cardiovascular disease, chronic lung or respiratory disease, or immunocompromise 1
• The benefits and risks of RSV vaccination, including the potential risk for Guillain-Barré Syndrome (GBS) 1
• The seasonal timing of vaccination for optimal protection during RSV season During her next visit, her healthcare provider should discuss these factors with JB, considering her individual health status, preferences, and the potential benefits and risks of RSV vaccination 1.

From the Research

RSV Vaccine Recommendations for Older Adults

The Advisory Committee on Immunization Practices (ACIP) recommends the use of RSV vaccines in adults aged 60 years and older under shared clinical decision-making 2. This recommendation is based on the efficacy and safety of RSV vaccines in preventing RSV-associated lower respiratory tract disease (LRTD) in older adults.

Eligibility and Efficacy

JB, a 62-year-old female with hypertension, GERD, and osteoarthritis, is eligible to receive an RSV vaccine. The ACIP recommends that adults aged 60 years and older may receive a single dose of an RSV vaccine, using shared clinical decision-making 2. Studies have demonstrated the efficacy of RSV vaccines in preventing RSV-associated LRTD in adults aged 60 years and older, with moderate to high efficacy rates 3, 4.

Factors to Consider

When considering RSV vaccination for JB, her healthcare provider should take into account her individual risk factors, such as her age and medical conditions. While JB's advanced age and medical conditions may increase her risk of severe RSV disease, her overall health and ability to maintain a regular exercise regimen should also be considered. The ACIP recommends shared clinical decision-making, which involves discussing the potential benefits and risks of RSV vaccination with JB and her healthcare provider 2.

Key Points

• The ACIP recommends RSV vaccination for adults aged 60 years and older under shared clinical decision-making 2.
• RSV vaccines have demonstrated efficacy in preventing RSV-associated LRTD in adults aged 60 years and older 3, 4.
• JB's healthcare provider should consider her individual risk factors and overall health when discussing RSV vaccination 2.
• The decision to vaccinate JB against RSV should be made through shared clinical decision-making between JB and her healthcare provider 2.