Residency in Long-Term Care Facilities: An Important Risk Factor for Respiratory Syncytial Virus Hospitalization

Older age and comorbid conditions increase risk for severe for respiratory syncytial virus (RSV). Skilled nursing facilities (SNFs) and assisted living (AL) facilities represent an intersection of risk factors. In a 3-year prospective study in Rochester, New York, we compared the population-based incidence of RSV-associated hospitalization for community-dwelling (CD), SNF, and AL adults aged >= 65 years. Their median ages were 76, 83 and 86 years, respectively, and dementia and congestive heart failure (CHF) were more prevalent among SNF and AL residents. The average annual incidences were 117 (95% confidence interval, 104-132), 440 (307-629) and 740 per 100 000 persons (523-1045), respectively, for CD, SNF, and AL adults aged >= 65 years, demonstrating a need for unequivocal RSV vaccine recommendations in SNF and AL residents. In a 3-year prospective, population-based incidence study, respiratory syncytial virus hospitalization rates among adults aged >= 65 years were 3-9 and 3-4 times higher for those admitted from assisted living or skilled nursing facilities, respectively, compared with community-dwelling adults.