Expert Consensus on RSV Prevention in Chinese Elderly: Addressing Misconceptions and Building a Comprehensive Protection Framework

Xinhua News Agency, Shanghai, October 12th, by Wu Qilong -- The 8th China International Import Expo (hereinafter referred to as "CIIE") was held in Shanghai from November 5th to 10th. During the event, "Silver Age Protection, 'Pre'-viewing the Future" – Building an Immune Barrier for Elderly RSV Respiratory Health and the Interpretation Meeting of the "Expert Consensus on Key Issues in the Prevention and Control of Human Respiratory Syncytial Virus Infection in the Chinese Elderly Population" was held at the GSK booth.

According to reports, as China's first expert consensus focusing on the prevention and control of Respiratory Syncytial Virus (RSV) in the elderly, it was led by the School of Population Medicine and Public Health of Peking Union Medical College, Chinese Academy of Medical Sciences. This consensus was developed over a year by 43 multidisciplinary experts from 22 institutions, providing scientific guidance for the prevention and control of RSV in the elderly.

Professor Feng Luzhao, Vice Dean of the School of Population Medicine and Public Health at Peking Union Medical College, stated in an exclusive interview with Xinhua News Agency that China's population aged 60 and above accounts for approximately 22% of the total population. The health threat of RSV to the elderly population has been severely underestimated. Prevention and control require the construction of a comprehensive system involving "monitoring and early warning - immunization and prevention - social intervention," with implementation through policy, education, and practice.

Feng Luzhao, Deputy Dean of the School of Population Medicine and Public Health, Peking Union Medical College

Cognitive Breakthrough: Unveiling the Hidden Risks of RSV Infection in the Elderly

On the public's awareness of RSV, Feng Luzhao pointed out two major misconceptions. "The first misconception is that RSV only poses a threat to infants and young children; in fact, both the very young and the elderly are high-risk groups." He explained that due to the decline in immune function, the elderly face significantly higher risks of severe illness, hospitalization, and death after RSV infection compared to younger adults. Particularly for elderly individuals with underlying conditions such as chronic obstructive pulmonary disease (COPD), diabetes, or cardiovascular diseases, an RSV infection can easily exacerbate their existing conditions or trigger acute episodes, potentially leading to serious complications like myocardial infarction or heart failure.

The second misconception is the "high fever bias" in infection monitoring. He explained that the current surveillance in China mainly focuses on fever cases above 38°C, but elderly people infected with RSV often present with low-grade fever or even no fever, leading to a large number of missed cases. Feng Luzhao revealed that global data shows that the RSV-related hospitalization rate for people over 75 years old reaches 256.33/100,000-294.3/100,000, while relevant disease burden data in China is still relatively scarce, which is also a key issue that the consensus urgently calls to address.

In addition to health risks, the economic burden cannot be ignored. "The medical expenses from hospitalization due to RSV infection in the elderly, plus indirect costs such as caregiving, are a heavy burden on both families and society," added Feng Luzhao.

Consensus Leadership: Building a Full-Chain Prevention and Control of "Monitoring-Immunity-Intervention"

As one of the lead authors of the consensus, Feng Luzhao provided a detailed interpretation of the key strategies and implementation pathways for RSV prevention and control in the elderly. Based on research evidence from within and outside China as well as field investigations, the consensus proposes the core concept of "comprehensive prevention and control" and identifies three major implementation pathways:

First, improve the monitoring and early warning system. "There is no need to build a new independent system; instead, it can be expanded based on the existing influenza surveillance and integrated surveillance of acute respiratory infections," said Feng Luzhao. By refining case definitions (including low-grade fever and non-fever cases) and adding population surveillance dimensions, precise data on RSV incidence, hospitalization, and mortality can be captured, providing scientific evidence for prevention and control decision-making.

Second, promote vaccination. The consensus is clear that vaccines are the key to RSV prevention. Currently, several RSV vaccines for older adults have been approved globally, including protein subunit vaccines and mRNA vaccines. "The development of relevant vaccines in China has entered the clinical stage. It is recommended to introduce mature vaccines while improving vaccination strategies for eligible populations," said Feng Luzhao.

Third, strengthen social intervention. "Public health measures such as wearing masks, hand hygiene, and environmental cleaning and ventilation can effectively reduce the risk of transmission." He reminded that elderly care facilities, nursing institutions, and other places with a high concentration of elderly people should establish a normalized prevention and control mechanism to implement prevention responsibilities through multi-departmental cooperation.

At the implementation level, Feng Luzhao summarized it as the "three transformations." In terms of policy transformation, it is recommended to draw on the established model for influenza prevention and control to build a systematic policy framework covering "monitoring and early warning, vaccination, critical care treatment, and science popularization," incorporating RSV into the system for the elderly’s “integrated prevention of multiple diseases.” The focus of science popularization transformation lies in leveraging the professional advantages of medical staff, with a recommendation to include RSV prevention knowledge in routine education for managing chronic diseases in the elderly. Practical transformation emphasizes the coordination of clinical diagnosis and treatment with disease control practices, promoting multipathogen testing and combined administration of multiple vaccines.

Vaccine Support: Building a Strong Immune Barrier for Elderly Respiratory Health

In terms of prevention and control measures, Arexvy, the world's first approved RSV vaccine unveiled at this year’s CIIE, has become the focus of attention. In an exclusive interview with Xinhua News Agency, George Zhao, Vice President of GSK and Head of Communications and Government Affairs in China, stated that the vaccine has been recommended for inoculation by the National Immunization Technical Advisory Groups (NITAG) of 19 countries and can provide protection for at least three epidemic seasons.

"RSV vaccine inclusion in the multi-disease prevention system for the elderly is of great significance to healthy aging and the construction of a public health system." Zhao Lun revealed that GSK is actively promoting the approval process of this vaccine in China, leveraging the CIIE platform to enhance communication with policymakers and medical experts, with the hope of providing protection to Chinese elderly as soon as possible.

Feng Luzhao also stated that the release of this expert consensus is just the beginning. It is hoped that through this consensus, the whole society will pay attention to the prevention and control of RSV in the elderly, so that the policy framework can be established as soon as possible, science popularization propaganda can be deeply rooted in people's hearts, prevention and control practices can be implemented at the grassroots level, and ultimately protect the respiratory health of hundreds of millions of elderly people, contributing to the realization of the Healthy China 2030 goals.