b'Microscopic respiratory syncytial virus, or RSV. It causes infections of the respiratory tract and lungs in newborns and young children. 3-D illustration.Adao/Shutterstocku FromPage 3andin-hospitaldeath(8.1%vs.4.0%; ARR,1.77;adults has historically been underappreciated by pub-95% CI, 1.36-2.31). lic health professionals and clinicians, the research-The study team emphasized that, over five RSV sea- ersemphasized.SurveillanceforRSV-associated sons, nearly one-quarter of hospitalized adults ageillness in adults has been hampered by infrequent 50 years or older with RSV infection experienced anclinical testing, as clinicians may choose not to test acute cardiac event (most frequently acute heart fail- because of limited awareness of RSV as an impor-ure), including 1 in 12 adults (8.5%) with no docu- tant pathogen in adults and because an RSV diagno-mented underlying cardiovascular disease. The risk ofsis does not typically change patient management.severe outcomes was nearly twice as high in patientsAdditionally,untilrecently,limitedtoolswere with acute cardiac events compared with patients whoavailabletopreventRSVinfection,althoughthis did not experience an acute cardiac event. These find- changedin2023whenthefirstRSVvaccinesfor ingsclarifythebaselineepidemiologyofpotentialadults age 60 years or older were approved and rec-cardiac complications of RSV infection prior to RSVommended in the U.S. via the use of shared clinical vaccine availability. decision-making, which takes into account the risks Backgroundinformationinthearticlenotedthatand benefits of RSV disease and vaccination, the cli-RSV is a seasonal respiratory virus that usually causesnicians knowledge and experience, and the patients mildupperrespiratorytractsymptoms,althoughitvalues and preferences.cancauseseverelowerrespiratorytractdiseaseinThe CDC advised that there are two RSV vaccines high-risk groups.licensed for use in adults age 60 years and older in the Amongadults,olderageandhistoryofchronicUnited States: GSK Arexvy and Pfizer Abrysvo. The medical conditions, including heart failure and coro- agency recommends that adults 60 years of age and nary artery disease, are risk factors for severe RSVolder may receive a single dose of RSV vaccine using illness requiring hospitalization, the authors pointedshared clinical decision-making (SCDM). This means out, adding that RSV has been associated with annualthathealthcareprovidersandtheirpatientsshould totals of up to 160 000 hospitalizations, 10 000 deaths,have a conversation to determine if RSV vaccination and $4.0 billion in direct healthcare costs among U.S.will be beneficial.adults age 65 years or older. The recommendation differs, however, from routine age-based and risk-based vaccine recommendations Severity Underappreciated for which the default decision is to vaccinate every-However, despite evidence of considerable RSV- one in a specified age group or risk group. associated morbidity, mortality, and health care ex- UnderSCDM,thereisnodefault,theCDC penditure, the potential severity of RSV infection inexplains on its website. Rather, the decision whether 4'