Respiratory Vaccine Safety for Older and Immunocompromised Adults

Respiratory infections remain a leading cause of morbidity and mortality among older adults and immunocompromised individuals worldwide. Age-related immune dysfunction, comorbidities, and immunosuppressive therapies increase susceptibility to severe disease and complications from respiratory pathogens such as the influenza virus, respiratory syncytial virus (RSV), SARS-CoV-2, and Streptococcus pneumoniae. Although vaccination is the most effective preventive strategy, concerns regarding safety, reactogenicity, and rare adverse events may limit vaccine uptake in these high-risk populations. Furthermore, immunosenescence and altered immune responses can modify both vaccine effectiveness and safety profiles, highlighting the need for population-specific evidence. Real-world data have become increasingly important to complement clinical trial findings, particularly in vulnerable groups often underrepresented in pivotal studies. A comprehensive evaluation of safety outcomes, pharmacovigilance data, and risk–benefit profiles is essential to guide clinical decision-making and public health policies. This Research Topic aims to consolidate current knowledge on respiratory vaccine safety in vulnerable adult populations.The goal of this Research Topic is to address the critical knowledge gaps surrounding the safety of respiratory vaccines in older and immunocompromised adults. Despite strong recommendations for influenza, pneumococcal, COVID-19, and, increasingly, RSV vaccination in these groups, safety data are often fragmented, derived from small subgroups in clinical trials, or limited by underreporting in routine pharmacovigilance systems. Clinicians and policy-makers must frequently extrapolate from healthier adult populations, which may not accurately reflect the risk profile in frail or immunosuppressed patients.This collection seeks to generate robust, context-specific evidence on adverse events, tolerability, and risk-benefit balance of respiratory vaccines in vulnerable adults. It will bring together clinical trials, observational studies, pharmacovigilance analyses, and mechanistic or immunological research.We invite contributions on the safety of respiratory vaccines in older and immunocompromised adults. We accept the following article types: original research, clinical trials, observational and registry-based studies, pharmacovigilance analyses, systematic reviews and meta-analyses, brief research reports, and perspectives or policy-focused reviews that address clinical, methodological or public health aspects of respiratory vaccine safety in high-risk adult populations.We especially welcome studies focusing on influenza, pneumococcal, COVID-19 and RSV vaccines, including single and combined vaccination strategies. Other subthemes of interest include:- Safety profiles and reactogenicity in frail or multimorbid older adults- Safety in patients with cancer, transplants, autoimmune diseases, HIV or other causes of immunosuppression- Real-world evidence and pharmacoepidemiology- Post-marketing pharmacovigilance and signal detection- Immunological mechanisms influencing safety (e.g. immunosenescence)- Impact of co-administration, booster schedules and heterologous regimens on safety outcomes.By integrating real-world data, comparative safety studies, and evaluations of co-administration strategies, this Research Topic seeks to inform clinical guidelines, support shared decision-making, and strengthen confidence in respiratory vaccination for high-risk populations. Topic editors: Francisco Guillen-Grima, Luc Onambele Source: https://www.frontiersin.org/research-topics/76619/respiratory-vaccine-safety-for-older-and-immunocompromised-adults