Effectiveness of the maternal RSVpreF vaccine against severe disease in infants in Scotland, UK: a national, population-based case-control study and cohort analysis.
Summary
Among 27,565 singleton births, maternal RSVpreF vaccination conferred an adjusted 82.2% effectiveness against infant RSV-LRTI hospital admission within 90 days, with benefit preserved in preterm infants (89.9%). A sensitivity cohort analysis yielded similar effectiveness (81.0%), supporting programmatic scale-up.
Key Findings
- Adjusted vaccine effectiveness against RSV-LRTI hospitalization in infants ≤90 days was 82.2% overall and 89.9% in preterm infants.
- Half of pregnant individuals (50.2%) received RSVpreF; most (92.1%) >14 days before delivery, the interval associated with protection.
- Sensitivity matched-cohort analysis confirmed effectiveness at 81.0%, translating to an estimated 219 admissions averted during the period.
Clinical Implications
Health systems should scale maternal RSV vaccination with equitable access, anticipate substantial reductions in infant RSV hospitalizations, and monitor multi-season durability and safety.
Why It Matters
Provides timely, real-world effectiveness evidence for maternal RSV immunization, informing policy during early rollout and supporting prioritization across gestational ages, including preterm births.
Limitations
- Observational design with potential residual confounding and early-season follow-up only
- Vaccine uptake ~50% may reflect differential access; generalizability across seasons/geographies requires monitoring
Future Directions
Evaluate effectiveness across multiple seasons, variant circulation, dosing intervals, and equity; integrate safety surveillance and cost-effectiveness analyses.
Study Information
- Study Type
- Case-control
- Research Domain
- Prevention
- Evidence Level
- III - Nested case-control with matched cohort sensitivity analysis using national linked data.
- Study Design
- OTHER