RS virus vaccination for older adults with chronic lung disease in the Netherlands, Digi Mart USA News (Netherlands): The RS virus can be life-threatening not only for babies but also for older people with chronic lung conditions such as COPD and severe asthma. According to lung specialists, these patients should receive a vaccine just as babies do, but it remains unclear whether a vaccine suitable for older adults will be reimbursed.
Within medical circles there is broad agreement that vulnerable older adults with a lung condition should be vaccinated. Lung specialists often see these patients arrive very ill at emergency departments in winter and have to admit them to hospital.
For a long time, the winter rise in admissions was attributed to the weaker health of older people combined with the many viruses circulating in this period.
It was not immediately clear that the RS virus was also the main culprit among these patients. It was previously thought that only babies were at risk, and in recent winters they ended up in pediatric intensive care units.
“We know better now,” says lung specialist Chantal Kroese of Ikazia Hospital in Rotterdam. “During the coronavirus pandemic a rapid test became available that allowed us to test for flu, corona and RS at the same time.
That is when you immediately saw the impact of this virus.”
Kroese says about 80 of her patients with a chronic lung condition had to visit the emergency department every winter as a result of the RS virus. “And you see that 75 percent of them had to be admitted for a longer period,” Kroese said.
“Such a disruption and worsening of a lung condition can be very dangerous.”
Over the past three years, people with chronic lung conditions spent 1,093 days at Ikazia Hospital, including 91 days in intensive care. Susanne Huijts, a member of the infectious diseases section of the Dutch Association of Lung Physicians (NVALT), recognizes this picture from Rotterdam.
She says it is similar elsewhere in the country. “I regularly see lung patients declining significantly after a respiratory infection.
They may no longer be able to do their own shopping, or they temporarily or permanently need more care.”
Vaccines are now available. “And they prove to be very effective,” Huijts says.
Her review of scientific studies shows that the vaccines offer a high level of protection to all adults aged 60 and over. Sampling in the United States showed the vaccines prevented more than 80 percent of hospital admissions.
In neighboring countries such as the United Kingdom, Germany and Belgium, the vaccine is fully or partly reimbursed for vulnerable older adults or for all people aged 75 and over. These countries report a clear decline in hospital admissions during winter.
However, the Dutch National Health Care Institute, an important advisory body to the cabinet, did not want to recommend reimbursement of the vaccine for vulnerable older adults last year. Although the vaccine appeared effective for older people in general, the institute reasoned that there had not yet been large studies on the effectiveness of the vaccines for vulnerable older adults.
“That is why there is still insufficient scientific evidence of effectiveness,” the spokesperson said. “And that is legally required.”
Nevertheless, the Long Alliance Netherlands is already calling for vaccination. Given the successes abroad, they regard the question of whether the vaccine also works for vulnerable older adults as outdated.
Lung specialist Kroese, together with her hospital, persuaded the health insurer to reimburse vaccines for her severely ill lung patients. “Then we will just do it ourselves.
Prevention is so important.”
The hospital vaccinated hundreds of patients last year. “You can already see a positive effect,” Kroese says.
In 2025, 95 people were admitted because of RS. After vaccination, the number of admissions has so far been limited to 34 people, a decrease of nearly two-thirds.
“Weigh the benefits,” Kroese says. “A vaccine costs about 200 euros, while a hospital admission quickly costs thousands of euros.”
In a response, the National Health Care Institute said that early in 2027 a new recommendation will be issued for three vaccines intended for people at increased risk of serious illness from the RS virus. “Compared with last year there is new evidence, including data on hospital admissions among medical risk groups that are prevented after vaccination,” the spokesperson said.
“In this assessment we also look at evidence on preventing hospital admissions after vaccination in people belonging to a medical risk group.”
