Exploring the success of Scotland’s older adult RSV vaccine programme – and why this matters to us all

Scotland has broken important new ground in protecting the population against respiratory syncytial virus (RSV) infection. A study published today and authored by a team from Public Health Scotland (PHS) and the University of Strathclyde, shows that the new RSV vaccine has significantly reduced hospital admissions for eligible older adults in Scotland. Dr Kimberly Marsh, interim Respiratory Viral Pathogens Lead at PHS, shares her thoughts on why the vaccine and this study matter to us all.

It matters that we protect our older adult population

RSV is a seasonal respiratory virus that can cause severe illness, especially in young children and older people. There were around 848 cases of RSV recorded in adults aged 75 and over in Scotland between October 2023 and September 2024, with more than half (439) having to spend time in hospital as a result.

Scotland launched its RSV vaccine programme in August 2024. For the first time, RSV vaccine was offered to adults aged 75–79 and those turning 75 before July 2025. The goal was to provide protection from severe illness before RSV cases start to rise, typically in late autumn. By November 2024, 68.6% of eligible older adults in Scotland had received the vaccine, which is currently thought to provide multi-year protection.

Without vaccination, hospital admissions for RSV in late 2024 were expected to rise in the eligible age group as infection levels increased. Instead, the vaccine helped prevent almost two thirds (62%) of the expected RSV related hospital admissions in the age group offered the vaccine during the study period.

This is the first published evidence from the UK that the vaccine works in a real-world setting. It also aligns with reports of robust protection from vaccine clinical trials and effectiveness studies elsewhere.

It matters that public health programmes work

PHS, NHS boards, and the Scottish Government acted quickly, and in partnership, to roll out the RSV vaccine and protect the majority of those eligible before rates of the seasonal infection rose.

PHS tracked and analysed the programme’s impact using real-time data. This fast, evidence-based approach to monitoring uptake and measuring impact is a model for monitoring future vaccination programmes.

The expert scientific Joint Committee on Vaccination and Immunisation Advisory Board is considering ways in which the results from this quick, responsive and data-led approach can help to improve future eligibility advice throughout the UK’s four nations.

It matters that Scotland has powerful public health and information science

Scotland’s health data systems allowed experts to rapidly analyse and then share the findings of this work in the Lancet. Scotland is a world leader in public health and information science – and it isn’t the first time that these strengths have advanced scientific understanding and influenced policy. In 2021, PHS worked with academic partners through the EAVE II project to use patient data to track the COVID-19 pandemic and vaccine roll out in real time, offering some of the first evidence worldwide that the vaccine prevented severe COVID-19 disease.

Since the launch of the programme in August last year, the RSV vaccine is also offered during pregnancy. In the coming months, PHS will also publish analysis of the impact of the RSV vaccine offered during pregnancy to help protect newborns and infants.

It matters that Scotland continues to innovate and protect its people

Scotland’s RSV vaccine programme highlights the power of strong public health action, science and data.

Investing in vaccines helps protect communities and reduces hospital admissions in older adults. Adding RSV to the winter immunisation programme, alongside flu and COVID-19 vaccines, provides additional protection for vulnerable people.

By utilising its world-class data systems and prioritising effective interventions, Scotland is paving the way in saving lives and reducing winter healthcare pressures.

More information on the RSV vaccine, including information about who is eligible, is available on NHS inform.

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