A look at the arguments for and against the RSV (Respiratory Syncytial Virus) vaccine, especially as it's being rolled out more widely in the UK

14th July 2025

the letters inviting older people for the RSV vaccine are popping through letter boxes. So we take look at the pros and cons.

Arguments For the RSV Vaccine
Protects vulnerable groups RSV can cause serious illness in infants, older adults, and people with chronic conditions. The vaccine helps prevent pneumonia, bronchiolitis, and hospitalisation.

Reduces healthcare burden In the UK alone, RSV leads to thousands of hospital admissions each year.
Vaccination programmes have already shown reductions in emergency visits and ICU admissions.

Effective in trials Vaccines like Abrysvo and Arexvy have shown strong efficacy—up to 89% in preventing severe RSV-related illness in older adults and 57% reduction in hospitalisation for babies when given during pregnancy.

One-time dose for older adults Unlike flu or COVID vaccines, RSV vaccines typically require only one dose for long-term protection (at least 2 years).

Available for pregnant women Maternal vaccination helps protect new-borns during their most vulnerable months.

Arguments Against the RSV Vaccine
Limited eligibility In the UK, adults over 80 are currently excluded from the free NHS programme, despite being at high risk. This has sparked criticism and confusion.

Rare but serious side effects There's a small increased risk of Guillain-Barre syndrome (GBS), a nerve condition, especially in older adults. However, the risk is estimated at fewer than 10 cases per million doses6.

Cost concerns for private access For those not eligible, private vaccination can cost upwards of £245, which may be prohibitive.

Insufficient long-term data Some critics argue that more research is needed, especially in the over-80 age group, where trial participation was low.

Not needed for most healthy adults RSV is usually mild in healthy individuals, so widespread vaccination may not be necessary outside high-risk groups.

Dr. John Campbell has discussed RSV vaccines in several of his videos and commentaries, often focusing on safety concerns and regulatory decisions.

Here's a summary of his key points:

On Moderna's mRNA RSV Vaccine (mRESVIA)
Campbell reviewed the FDA’s approval of mRESVIA, an mRNA-based RSV vaccine for adults aged 60+.

He highlighted the breakthrough therapy designation, but also raised questions about long-term safety and the novelty of mRNA platforms for RSV.

On Paused Pediatric Trials
He covered the suspension of a pediatric RSV vaccine trial in the U.S. due to a safety signal.

The trial involved children under 2 years old, and several cases of severe lower respiratory tract illness (sLRTI) were observed in vaccinated groups.

Campbell expressed concern about vaccine-associated enhanced respiratory disease (VAERD), a rare but serious complication where the vaccine may worsen symptoms upon infection.

General Tone and Approach
Campbell tends to take a cautiously skeptical stance on new vaccines, especially those using mRNA technology.

He often urges transparency from regulators and encourages viewers to critically examine trial data and official reports.

What are the issues with mRNA vaccines
mRNA vaccines—like those used for COVID-19 and now RSV—have revolutionized immunization, but they’re not without challenges. Here’s a breakdown of the key issues that have emerged from large-scale studies and expert reviews:

Known Safety Concerns
Myocarditis and Pericarditis Rare inflammation of the heart muscle or surrounding tissue, especially in young males after the second dose of mRNA COVID vaccines. Most cases are mild and resolve with rest2.

Neurological Conditions A massive global study flagged rare cases of:

Acute disseminated encephalomyelitis (ADEM) - inflammation of the brain and spinal cord

Transverse myelitis – spinal cord inflammation These occurred at rates of less than 2 cases per million doses.

Allergic Reactions Anaphylaxis (severe allergic response) happens in about 5 per million vaccinated individuals. It’s treatable and usually occurs within minutes.

Scientific and Technical Limitations
Temperature Sensitivity mRNA vaccines require ultra-cold storage, making distribution harder in low-resource settings.

Limited Long-Term Data While short-term safety is well studied, long-term effects—especially for newer applications like RSV—are still being monitored.

Immune Overactivation Some studies suggest that rare side effects may stem from an overactive immune response, not the mRNA itself.

Equity and Access Challenges
Global Distribution Gaps Many low- and middle-income countries struggled to access mRNA vaccines due to cost, patents, and cold-chain logistics.

Misinformation and Hesitancy Misunderstandings about mRNA technology have fuelled vaccine hesitancy, despite strong safety records.

Despite these concerns, experts—including the WHO and CDC—emphasize that the benefits of mRNA vaccines far outweigh the risks for most people

You can find plenty of research online but in the end you must weigh up the risks for and against for yourself.