Impact of RSVpreF vaccination on reducing the burden of respiratory syncytial virus in infants and older adults.

Summary

An individual-based model across 13 high-income countries projects that RSV prefusion F vaccines could prevent 35–64% of older-adult hospitalizations and 5–50% of infant hospitalizations, with mortality reductions mirroring hospitalization declines. The analysis assumes no effect on infection/transmission and underscores that impact is highly contingent on vaccine uptake.

Key Findings

• Older-adult RSV vaccination prevented an estimated 35–64% of hospitalizations across 13 high-income countries.
• Maternal RSV vaccination averted 5–50% of infant hospitalizations.
• Mortality reductions mirrored hospitalization reductions; overall impact was highly dependent on uptake assumptions.
• Model assumed no prevention of infection/transmission, focusing on disease mitigation.

Clinical Implications

Health systems should prioritize strategies to maximize uptake (e.g., co-administration, outreach) among older adults and pregnant women, as real-world benefit hinges on coverage. Economic planning should account for substantial hospitalization cost savings.

Limitations

• Assumes no effect on infection/transmission; real-world indirect effects may be underestimated
• Uses influenza vaccine uptake as a proxy for RSV vaccine uptake; generalizability limited to high-income settings

Future Directions

Incorporate uncertainty in transmission-blocking effects and dynamic uptake scenarios, extend to low- and middle-income countries, and integrate cost-effectiveness and equity metrics.