Expert Consensus Statement on the Disease Burden and Vaccination for Respiratory Syncytial Virus Infection in Adults

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection in adults, with higher morbidity and mortality in older adults and those with chronic obstructive pulmonary disease (COPD) or asthma. Despite the burden, disease awareness remains low and treatment is limited to supportive care. Recent advances have led to the approval of multiple vaccines and updated guideline recommendations. We reviewed current literature, surveillance data, and international guidelines to assess the burden of RSV in adults and to evaluate evidence for vaccination in high-risk groups. Globally, RSV accounts for millions of infections and substantial hospitalizations and deaths among adults ≥60 years. COPD and asthma patients show disproportionately high risks of RSV-related hospitalization, exacerbations, and mortality. South Korean studies confirm RSV as a major contributor to pneumonia, COPD and asthma exacerbations, and bronchiectasis. As of 2025, three RSV vaccines (Arexvy, Abrysvo, mRESVIA) have US Food and Drug Administration approval; only Arexvy is approved in Korea for older adults. Advisory Committee on Immunization Practices (ACIP) now recommends vaccination for all adults ≥75 years and high-risk adults aged 50-74 years, while Global Initiative for Chronic Obstructive Lung Disease (GOLD), Global Initiative for Asthma (GINA), and Korean COPD guidelines endorse RSV vaccination for chronic respiratory disease patients. RSV is underrecognized yet imposes significant disease and healthcare burdens in older adults and those with chronic respiratory diseases. In the absence of effective antivirals, vaccination is a key preventive strategy. Expanding vaccination uptake, improving awareness, and integrating RSV vaccines into national immunization programs could substantially reduce RSV-related morbidity and mortality.