Addressing RSV infection in older adults: implications for public health policy

Background: The aging population increases healthcare challenges, especially in preventing infectious diseases. Respiratory syncytial virus (RSV), historically associated with pediatric illness, is now recognized as a significant cause of severe disease and mortality in older adults. Despite scientific advances, including new RSV vaccines, adult immunization policies across Europe remain fragmented and underdeveloped. Research design and methods: This study, promoted by the World Federation of Public Health Associations (WFPHA), assessed RSV surveillance, vaccination strategies, and capacity-building effort in eight European countries (Bulgaria, Finland, Germany, Italy, Norway, Portugal, Spain, and Serbia). A structured questionnaire, informed by a preliminary literature review, was administered to a panel of 19 experts, with a 79% (15/19) response rate. Results: Findings revealed marked heterogeneity and persistent gaps across countries, including fragmented RSV surveillance, limited or missing vaccine recommendations for older adults, lack of age-specific monitoring, and insufficient training and communication initiatives for healthcare providers and the public. Conclusion: To address these issues, the expert panel proposed policy recommendations to improve surveillance, ensure equitable vaccine access, and enhance professional training and awareness, providing a roadmap for stronger, prevention-focused healthcare across Europe.