- "According to the U.S. Centers for Disease Control and Prevention, each year in the U.S., RSV leads to approximately 60,000-120,000 hospitalizations and 6,000-10,000 deaths among adults 65 years of age and older."

Those are respectively 0.1 – 0.2%, and 0.01% – 0.02%, annual risks for this subgroup (55 million persons).

The OP discusses three studies, with a combined N of about 17,500 (12,500 + 2,500 + 2,500) (the non-placebo groups). They apparently attribute one death to this vaccine (in combination with an influenza vaccine), which is 0.006% of the participants of the three studies.

I don't know how to interpret this. The FDA's endpoints are "RSV-associated [lower respiratory-tract disease]" and "severe RSV-associated LRTD". Okay. I guess they're ignoring mortality because its small-number statistics aren't meaningful to interpret. But then why endorse a vaccine at all, if the mortality rate is so low? You'd need a vastly larger study to answer the question "does this therapy increase or decrease the risk of death", because the probabilities are microscopic on both sides.