Disparities in Respiratory Syncytial Virus Risk Factors, Diagnosis, and Outcomes in Adults by Race, Ethnicity, and Other Social Determinants of Health in the United States
Creators: name: Horn, Emily K.
name: La, Elizabeth M.
name: Bektas, Meryem
name: Khan, Shahnaz
name: Gerber, Susan I.
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Medicine
subject: Pharmacology
subject: Biotechnology
subject: Sociology
subject: FOS: Sociology
subject: Cancer
subject: Science Policy
subject: Mental Health
subject: Infectious Diseases
subject: FOS: Health sciences
subject: Virology
subject: Computational Biology

description: Respiratory syncytial virus (RSV) vaccination could improve health equity by protecting individuals who are disproportionally at increased risk of RSV infection and severe RSV-related outcomes. However, limited information is available about RSV-related disparities among United States (US) adults. We reviewed US-specific literature regarding disparities across adult populations in having risk factors for severe RSV disease (cardiopulmonary disease, diabetes, liver disease, kidney disease). We summarize available evidence regarding disparities in having or being diagnosed with RSV, as well as experiencing severe RSV-related health outcomes. Disparities are analyzed by race, ethnicity, socioeconomic status, and other social determinants of health. RSV-related disparities are observed across all outcomes of interest, although RSV-specific data are limited in some cases. Racial and ethnic minority groups and socioeconomically disadvantaged populations are more likely to have risk factors for severe RSV disease, overall and at younger ages, yet individuals from these groups are more often underdiagnosed. Disparities in RSV-related hospitalizations, emergency department visits, and deaths are observed, especially among adults from racial and ethnic minority groups, of lower socioeconomic status, and in poorer or more crowded neighborhoods. Findings highlight the importance of RSV vaccination among these groups to improve health equity. In most adults, respiratory syncytial virus (RSV) causes mild symptoms. However, older adults and adults with health conditions, such as heart disease, asthma, or diabetes, are more likely to have more severe symptoms and be hospitalized, and may even die from their RSV infection. RSV vaccines, which are available in the US for older adults, protect against severe RSV disease. It is important to identify the specific groups of people who could benefit from RSV vaccination. In this study, we summarize differences between groups of US adults who have health conditions that may place them at higher risk of severe RSV disease. We also summarize differences between groups in becoming infected with RSV and having more severe outcomes from RSV infection. Existing studies show that adults who are from racial and ethnic minority groups, who are poorer, who have a low level of education, or who have no health insurance are more likely to have chronic diseases, putting them at higher risk of severe RSV disease than other adults. Adults from these disadvantaged groups are also more likely to be infected with RSV than those from more advantaged groups. Additionally, adults who are from racial and ethnic minority groups, who live in poor or crowded neighborhoods, or who have Medicaid or no health insurance are more likely to be hospitalized, visit the emergency department, or die from their RSV infection. One way to reduce health disparities is to ensure that disadvantaged adults are vaccinated against RSV.