Among adults, who is most at risk for serious RSV infection?

Most adults experience a mild upper respiratory tract infection with RSV, with symptoms lasting only a few days. Some adults with RSV develop lower respiratory tract disease, including pneumonia. Because public health surveillance and testing for RSV in adults been limited in the past, our estimates of the burden of RSV disease are not precise and may underestimate the true burden among adults. Among U.S. adults age 65 and older, RSV is responsible for approximately 60,000 to 160,000 hospitalizations and 6,000 to 10,000 deaths each year.

The risk for severe RSV infection increases substantially with increasing age, especially among those who are 75 years of age and older. Risk is also increased for those who have one or more chronic health conditions, including people who are moderately or severely immunocompromised and people who are considered frail or who live in a nursing home or long-term care facility.  Among those with health conditions, the risk of hospitalization is goes up significantly with age and among those who have multiple health conditions. To review the specific high-risk conditions that ACIP considers important for vaccination of adults age 60 through 74 years, see this question.