Call for RSV vaccine subsidies for elderly as severe hospitalisations on rise
RSV has outstripped severe Covid and flu hospitalisation rates and proved itself more deadly than either of the flu season staples, according to government data.
Respiratory syncytial virus is sending more people to hospital and has proved deadlier than either flu or Covid, the latest government data shows.
The June 16-29 Australian Respiratory Surveillance Report showed RSV caused the largest share of hospital admission for severe acute respiratory infection – 37 per cent of the total.
Of those admitted to hospital, 4.1 per cent of patients with RSV died compared with 2 per cent of flu patients and 3.5 per cent of those with Covid.
There were more than 15,000 cases of RSV reported in Australians aged over 65 this year, 9400 of which were in over-75s.
However, vaccination rates for RSV remain relatively low. There is no universally subsidised vaccination program for adults and vaccines cost as much as $320.
While infant patients constituted most RSV hospitalisations, the Australian Medical Association, Immunisation Foundation of Australia and Immunisation Coalition have called for elderly Australians to be offered subsidised RSV vaccines as a part of the National Immunisation Program.
Abrysvo – one of two RSV vaccines offered in Australia – retails from $280 to $320 a dose but in November the federal government’s independent medicine subsidy referee, the Pharmaceutical Benefits Advisory Committee, suggested it be funded and provided to those aged over 75.
The PBAC also suggested Indigenous Australians and those with a compromised immune system be offered the vaccine from age 60 and up. Its recommendation has been in limbo since.
“The prevention and treatment of RSV is a priority for the Australian government,” a Health Department spokesperson said.
“Whilst a positive PBAC recommendation is an essential requirement in the NIP (National Immunisation Program) listing process, other steps need to be completed before a vaccine can be given final approval for NIP listing,” the spokesperson said. “The Department of Health, Disability and Ageing will actively work with vaccine sponsors following a positive PBAC recommendation.”
AMA vice-president Julian Rait said the winter flu season drew attention to the vulnerability of elderly Australians and good health economics required investment in vaccines that prevented costly hospitalisations.
“We would like to have seen (a subsidy) done sooner rather than later,” Dr Rait said. “The real problem we’re having at the moment is we’re having a real surge of respiratory infections.
“Older people tend to get influenza and Covid more frequently compared to RSV, but nevertheless RSV is a significant cause of morbidity and hospitalisations in older people.
“We’d encourage some reform of the vaccine reimbursement pathway so we can have these vaccines more readily available for older people.”
Child hospitalisations for RSV also beat out relative Covid and flu rates in the first half of the year.
Pensioner John Schultz, 76, was brought to the brink of death after he came down with RSV this month, spending four days at Queen Elizabeth Hospital in Adelaide – 12 hours in intensive care.
He had never heard of the virus before he caught it and was especially vulnerable given his pre-existing heart problems and a lung condition from asbestos exposure.
“I started feeling unwell and two days later, in the evening, I got to a stage where I was really struggling to breathe and my heart was thumping,” Mr Schultz said.
“We got an ambulance and I went straight into Queen Elizabeth Hospital. All night and into the next morning they were working on me to try and get me breathing better and bring my heart rate down. It took them 12 hours to get my heart rate down to an acceptable level. It was pretty scary knowing that it was bad.
“They didn’t mince words; they told me I was lucky to be alive. I thought I was a goner. I struggled badly to breathe the whole time I was in there.”
Mr Schultz would be eligible for subsidised vaccination under the terms recommended by the PBAC. He shares a house in Queenstown with his sister and an elderly friend but said his pension allowance was tight enough that the $320 vaccine cost would require more than a month of budgeting.
“Obviously RSV is a really serious and quite unpredictable virus that does impact a lot of Australians, both the very young and the very old,” Immunisation Foundation of Australia founder Catherine Hughes said.
“I think we’ve made great progress by introducing a program to protect little babies, but unfortunately for our older Australians it’s quite an inequitable situation we find ourselves in.
“We know the older Australians are disproportionately affected by RSV, and there is a recommended vaccine available, but it’s not accessible to these Australians.”
Last week the Victorian government announced it would fund RSV vaccination for all aged care residents aged 60 and older. The $2.2m program offered doses of the alternate RSV vaccine Arexvy.
The federal government’s immunisation handbook suggests RSV vaccination for all those aged over 75, and potential immunisation for those aged 60 to 74.
“We have RSV vaccines that should be available for adults and it would be nice to see Australia follow the lead of Victoria, get approval and give the thumbs up for it to be given in elderly patients,” Immunisation Coalition chairman Rod Pearce said.
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