There's good news for RSV jab firms at delayed ACIP meeting

The delayed meeting of the CDC's main vaccines advisory committee has taken place, with new recommendations on respiratory syncytial virus (RSV) vaccines that do away with restrictions imposed last year.

The Advisory Committee on Immunisation Practices (ACIP) has voted to widen the recommendations on the use of RSV shots to include people aged 50 to 59 who are at increased risk of RSV-associated lower respiratory tract disease (LRTD), such as those with asthma, diabetes, and heart disease.

That is good news for GSK and Pfizer, whose RSV vaccines – Arexvy and Abrysvo, respectively – are already approved by the FDA to treat that patient group, as well as older people. A third vaccine from Moderna (mResvia) is currently cleared to protect the 60-and-over age bracket only.

The ACIP meeting was originally scheduled to take place in February, but was postponed by the new Health and Human Services (HHS) Secretary Robert F Kennedy Jr amid the disruption and job cuts in the CDC and other HHS agencies introduced under the new Trump administration.

In 2023 – the first year that Arexvy and Abrysvo were approved – the ACIP's recommendation was that they could be used in all adults over the age of 60 if deemed appropriate by their doctor, and sales quickly ramped up to blockbuster levels.

That was followed by a much narrower recommendation the following year, however, limiting their use to the over-75s and at-risk people in the 60 to 74 age range in the 2024 season. That read directly through to sales, with Arexvy falling 52% to £590 million ($781 million) and Abrysvo down 15% to $890 million last year.

GSK said the new guidance – which it is worth pointing out still needs to be approved by the CDC – suggests that RSV causes approximately 42,000 hospitalisations each year in adults aged 50 to 64 years old, estimating there are around 13 million eligible people in the 50 to 59 group.

Pfizer suggested that between 15,000 and 20,000 RSV-associated hospitalisations occur annually in people aged 50 to 59 years.

Other recommendations coming from the ACIP meeting include the use of Bavarian Nordic's chikungunya vaccine Vimkunya in people aged 12 and over travelling to a country or territory where there is an outbreak of the disease.

Panellists also discussed changing from a broad to a risk-based strategy for COVID-19 vaccination, which would be a major change in direction, and will be voted on at the next meeting scheduled for June.

The proposal by a CDC official ties in with the views of some senior officials in HHS agencies, including FDA Commissioner Martin Makary, who criticised the widespread COVID-19 vaccination strategy adopted during the pandemic.