Reducing the burden of viral respiratory infections on aging adults

For aging populations, viral respiratory infections can be a formidable challenge. The collective burden of respiratory infections can diminish quality of life for older adults and places substantial strain on healthcare systems worldwide, requiring a comprehensive and proactive approach to prevention.1 At AstraZeneca, we strive to reduce these burdens through innovative technologies that maximise the potential of vaccines and protect as many people as possible, especially those who are at highest risk of severe outcomes from respiratory viruses. 

The impact of viral respiratory infections on high-risk populations

As the population of adults aged 60 years and above is expected to more than double in the next 35 years, addressing the needs of this aging group has emerged as a significant global priority.1 Viral respiratory infections such as COVID-19, influenza, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are common in older adults and can exacerbate morbidity, presenting an especially burdensome challenge on quality of life and healthcare systems overall.1 The burden of respiratory infections in older populations was highlighted during the COVID-19 pandemic, with increased age proving to be the biggest risk factor for morbidity and mortality.1

The presence of chronic diseases, such as cardiovascular, renal and respiratory diseases, as well as other co-morbidities are common in older adults and are top risk factors for contracting severe viral respiratory infections.1 The prevalence of multi-morbidities coupled with a decreased physiological reserve, a waning immune system and a greater likelihood of atypical symptom presentation are driving factors behind why viral respiratory infections are more burdensome in older adults.1

Influenza, COVID-19, RSV and hMPV are among the five respiratory viruses in the US tracked by the CDC in older adults and lower respiratory tract infections overall are the leading cause of hospitalisation in elderly patients with infectious disease2,3. For example, most adult cases of RSV, a common and contagious virus, occur among older adults with an estimated 60,000-160,000 hospitalisations and 6,000-10,000 deaths annually in the US.4 RSV infection can cause serious complications such as pneumonia or exacerbation of congestive heart failure, asthma and chronic obstructive pulmonary disease.5

Like RSV, hMPV causes upper and lower respiratory tract infections that can be more severe in older adults and people with weakened immune systems.6 Research shows that in a population where 78% were vaccinated for influenza, hospitalisations associated with hMPV and RSV were almost double that of influenza hospitalisation rates.7 Older adults with hMPV infection may have viral pneumonia, worsening asthma or COPD symptoms.8

On top of the already burdensome physical impacts, respiratory infections like RSV and hMPV in older adults and those with weakened immune systems can profoundly affect their quality of life.1 Increased dependency on healthcare resources and physical discomfort are just two of many factors that can lead to heightened emotional and psychological distress.

Prevention and next-generation vaccines

Increased awareness of the risks of contracting respiratory disease over 60 years of age is critical in ensuring this vulnerable population is taking basic and essential steps in prevention, such as washing hands often, staying home when sick and keeping vaccinations up to date. The importance of vaccination, especially for common infections like influenza, COVID-19 and RSV, cannot be stressed enough for older adults and is reflected in recent guidelines.9-11 There are currently no treatment or prevention options for hMPV.

At AstraZeneca, we are exploring innovative technologies that will offer protection against viral respiratory infections. For example, investigating combination vaccines may offer protection against more than one disease with fewer doses, offering the potential to improve access and better protect vulnerable populations. Additionally, we’re exploring the role of prophylactic monoclonal antibodies as a protective option for people who cannot mount an effective response to immunisation.

Drawing upon decades of experience in vaccine development, we are harnessing our expertise to make access to next-generation vaccines a reality and ultimately lessen the burden of serious respiratory infections for everyone, particularly for the growing population of aging adults who are most vulnerable.

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1. Watson A, Wilkinson TMA. Respiratory viral infections in the elderly. Ther Adv Respir Dis. 2021;15:1753466621995050. doi:10.1177/1753466621995050

2. National respiratory and enteric virus surveillance system | cdc. Published February 1, 2024. Accessed February 9, 2024.

3. H. Keipp Talbot, Ann R. Falsey, The Diagnosis of Viral Respiratory Disease in Older Adults, Clinical Infectious Diseases, Volume 50, Issue 5, 1 March 2010, Pages 747–751,

4. Havers FP, Whitaker M, et al. Characteristics and Outcomes Among Adults Aged ≥60 Years Hospitalized with Laboratory-Confirmed Respiratory Syncytial Virus - RSV-NET, 12 States, July 2022-June 2023. MMWR Morb Mortal Wkly Rep. 2023 Oct 6;72(40):1075-1082.

5. RSV in Older Adults and Adults with Chronic Medical Conditions. CDC. Published 7 November, 2023. Accessed 6 December 2023.

6. Human metapneumovirus. CDC. Published 20 September 2023. Accessed 5 December 2023.

7. Widmer, K., Zhu, Y., Williams, J. V., Griffin, M. R., Edwards, K. M., & Talbot, H. K. (2012). Rates of hospitalizations for respiratory syncytial virus, human metapneumovirus, and influenza virus in older adults. The Journal of infectious diseases206(1), 56–62.

8. Human metapneumovirus (hMPV). Cleveland Clinic. Accessed February 9, 2024.

9. ACIP COVID-19 vaccine recommendations | CDC. Published December 12, 2023. Accessed February 9, 2024.

10. ACIP influenza vaccine recommendations | CDC. Published September 8, 2023. Accessed February 9, 2024.

11. RSV ACIP vaccine recommendations | CDC. Published December 19, 2023. Accessed February 9, 2024.

Veeva ID: Z4-61805
Date of preparation: February 2024