ABSTRACT Background Respiratory syncytial virus (RSV) vaccines are approved in the United States (US) among adults ≥ 60 years of age (YoA). Understanding disparities in risk factors (RFs) for severe RSV disease by social determinants of health is crucial for equitable RSV vaccination among at‐risk adults. We investigated diagnosed/undiagnosed RF prevalence, age at RF diagnosis/identification, and association of key characteristics with RF diagnosis/identification among US adults. Methods We analyzed 2011–2020 National Health and Nutrition Examination Survey (NHANES) data to calculate RF prevalence and mean age at RF diagnosis/identification. Multivariable regression models were developed to estimate associations between characteristics and RF diagnosis/identification. Results were weighted to reflect the US noninstitutionalized adult population ≥ 20 YoA. Results After weighting, the analysis included a sample of 233,118,491 adults. Overall, 28.0% had ≥ 1 diagnosed RF (12.8% pulmonary; 9.2% cardiovascular; 14.1% endocrine/metabolic). Undiagnosed diabetes and renal disease were identified in 3.7% and 12.5% of adults, respectively. Among those with ≥ 1 diagnosed RF, mean age at RF diagnosis was 40.1 years and 60.0% were diagnosed before 50 YoA. Increasing age, belonging to a racial or ethnic minority group, and lower income were significantly associated with having ≥ 1 RF. Conclusions Approximately one in four adults had ≥ 1 diagnosed RF for RSV, with most diagnosed before 50 YoA. Adults in racial and ethnic minority and socioeconomically disadvantaged groups were more likely to have RFs and be diagnosed at younger ages. Efforts are needed to ensure all US adults at increased risk for severe RSV disease have access to RSV vaccination.
Horn et al. (2025) studied this question.