Tommaso Morelli and colleagues present a timely and methodologically robust study that sheds new light on how risk (for poor outcome) could be assessed in adults hospitalised with respiratory syncytial virus (RSV) infection in the UK.1 Using data from a multicentre cohort of 334 patients with PCR-confirmed RSV-related acute respiratory infection, the authors critically evaluate the relevance of existing age-based thresholds used by the Joint Committee on Vaccination and Immunization for guiding RSV vaccine eligibility. Their findings show that simple age-based cut-offs applied currently, such as ≥75 years (or even ≥60 years), offer only limited discriminatory power for predicting Intensive Care Units (ICU)/High Dependency Units (HDU) admission or 60-day mortality, with optimism-adjusted AUCs between 0.58 and 0.61. By contrast, a more clinically nuanced model incorporating age, chronic obstructive pulmonary disease (COPD), current or past cancer and dementia yielded a considerably higher area under the curve (AUC) of 0.77…