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

BACKGROUND: 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.

RESEARCH DESIGN AND METHODS: 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.

RESULTS: 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.

CONCLUSIONS: 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.