US seniors' intention to vaccinate against RSV in fall and winter 2023-2024

In the fall and winter of 2023-2024, the United States may experience a "tripledemic" of COVID-19, influenza, and respiratory syncytial virus (RSV) that may lead to 100 000 deaths. Seniors will be disproportionally affected. The newly released RSV vaccines for those age 60 years and over may reduce the number of deaths for the expected 6000 to 10 000 seniors expected to die from RSV alone. Using a large national survey, we queried Americans over age 60 about their RSV vaccination status and their intention to vaccinate this fall and winter. We found that 9% of seniors had already been vaccinated. Of the remaining unvaccinated, 42% indicated their intent to vaccinate. We found that those with higher levels of concerns for the disease, higher levels of self-assessed risk, believing that vaccines were safe and important, higher levels of trust in health institutions, and men were more likely to seek out vaccinations. Vaccine-hesitant respondents listed a lack of necessity, concerns about side effects and safety, and a lack of information as primary reasons. The large number of unvaccinated seniors will likely lead to an excessive number of hospitalizations and deaths as well as augmented social costs. Evidence-based mitigation measures tailored to seniors' concerns should be implemented immediately.