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Peer reviewedCOVID-19Influenza

IDSA 2025 Guidelines on the Use of Vaccines for the Prevention of Seasonal RSV Infections in Immunocompromised Patients

Clinical Infectious Diseases·

Chen Sabrina Tan, Shweta Anjan, Ella J Ariza-Heredia, Francisco Magana, Timothy D Minniear, Dipleen Kaur, Yngve Falck-Ytter, Lindsey Baden

DOI
10.1093/cid/ciag117
PMID
41766598
PMCID
OpenAlex
Study type
Systematic review
Publisher
Oxford University Press (OUP)
Article type
journal-article
Integrity
current

Why this research matters now

The article is relevant to vaccination policy and prevention planning for RSV among people with compromised immunity, a group identified in the abstract as experiencing more severe RSV outcomes. It also addresses coadministration with influenza and COVID-19 vaccines and vaccination status among eligible household members.

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Structured evidence summary

Research question

The article addresses how RSV vaccination should be used to prevent seasonal RSV infection and severe outcomes among immunocompromised adults and children for the 2025-2026 respiratory virus season.

Study design

This is described as a systematic review supporting rapid, evidence-based guideline recommendations. The panel reviewed comparative effectiveness and harms literature from August 2024 through July 2025, added evidence from the Vaccine Integrity Project, and applied GRADE to judge certainty and recommendation strength.

Population and setting

The target population is immunocompromised adults, adolescents, and children, with attention to subgroups such as transplant recipients, patients in treatment cycles, and those receiving B-cell-depleting therapies. The guideline context is seasonal RSV prevention, with additional mention of eligible household members.

Main findings

Two test-negative case-control studies in immunocompromised adults reported a 70% reduction in RSV-related hospitalization after vaccination, with a 95% confidence interval of 66% to 73%. Indirect evidence from older adults reported 81% effectiveness against critical illness, and three randomized trials found similar serious adverse event rates between vaccinated and unvaccinated groups. The abstract also reports rare Guillain-Barre syndrome, estimated at 11 additional cases per million doses.

Public-health relevance

The article is relevant to vaccination policy and prevention planning for RSV among people with compromised immunity, a group identified in the abstract as experiencing more severe RSV outcomes. It also addresses coadministration with influenza and COVID-19 vaccines and vaccination status among eligible household members.

Important limitations

The abstract states that direct evidence for RSV vaccination in immunocompromised populations is limited, and some effectiveness evidence was indirect from older-adult populations. Additional interpretation is limited by reliance on the supplied single-article abstract and metadata; the full article would be needed for decision-grade assessment.

GIDS interpretation

Within a GIDS-style discovery context, this record is identifiable through its RSV vaccination focus, systematic-review study type, and classifier topics for vaccination, treatment, and health policy. The classifier links also associate the record with COVID-19 and influenza because the abstract discusses vaccine coadministration, but the supplied evidence does not establish country-specific context.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 11 auditable classifier relationships to diseases, places, topics, and study design.

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