Adjuvanted-RSVPreF3 vaccine uptake and effectiveness in individuals with COPD: a nationwide Danish cohort study

Individuals with chronic obstructive pulmonary disease (COPD) face increased risk of severe respiratory syncytial virus (RSV)-related outcomes. We assessed the uptake of adjuvanted-RSVPreF3 and its effectiveness against RSV hospitalization in such individuals. We assembled a Danish nationwide cohort of individuals aged ≥ 60 years with COPD during the 2024/25 RSV season. Vaccinated and unvaccinated individuals were matched using exact and propensity score matching resulting in balanced groups. Individuals were followed from 21 days post-vaccination until the earliest of event, end of data availability, migration, RSV vaccination, or death. Vaccine effectiveness was estimated as (1 – incidence rate ratio [IRR]) x 100, where IRRs were calculated using observed event counts and accumulated person-time. Confidence intervals (CIs) were based on Poisson distributions. Among 126,249 eligible individuals, 7,448 (5.9%) received adjuvanted-RSVPreF3. RSV hospitalization rates per 100,000 person-years were 0.0 (95% CI: 0.0—58.0) for vaccinated individuals and 200.6 (165.6 – 240.8) for unvaccinated individuals, yielding an effectiveness of 100.0% (71.1—100.0). Incidences of other RSV-related outcomes were lower among vaccinated individuals. Adjuvanted-RSVPreF3 is highly effective in preventing RSV hospitalization in individuals aged ≥60 years with COPD. Disease outcomes could be improved by incorporating RSV vaccination into routine COPD management. Respiratory syncytial virus (RSV) is a virus that most healthy adults recover from without experiencing serious health problems. However, older adults or individuals with chronic conditions such as heart or lung disease may become very unwell. Newly available vaccines for RSV can help prevent RSV infection and related complications. Many countries recommend vaccination for people aged 60 years or older and those at increased risk of severe disease. We wanted to understand more about how RSV vaccines help specific groups of people, such as individuals with chronic obstructive pulmonary disease (COPD). We aimed to find out how many individuals with COPD living in Denmark had received the adjuvanted-RSVPreF3 vaccine and then we subsequently compared the health of vaccinated and unvaccinated individuals. About 6% of the Danish older adults living with COPD had been vaccinated with the adjuvanted-RSVPreF3 vaccine in the 2024/25 season. None of the vaccinated individuals were hospitalized due to RSV infection and they experienced fewer other health problems and complications related to RSV than the unvaccinated individuals. These results suggest that improving RSV vaccination uptake could be a very important way to help patients with COPD to stay as healthy as possible. This study is a first step toward helping doctors and their patients understand the importance of having an RSV vaccine.