Chronic Conditions Significantly Increase Risk of Severe RSV Outcomes in Medicaid Beneficiaries Aged 18-59 Years: A Claims Data Analysis
Author(s)
Linwei Li, MS in Biostatistics1, Meng Wang, PhD1, Miao Jiang, PhD1, Daniel K. Nomah, MD, MSc, PhD2, John Shen, MSPH3, Neloufar Rahai, PhD, MPH3, Isabella Lelis, BA3, Parinaz Ghaswalla, PhD1, Genelle Goodhue, BS1, Beverly Francis, PhD1, Claire E. Newbern, PhD, MPH1, Catherine A. Panozzo, PhD1, Elissa Wilker, ScD1, Zhe Zheng, PhD1;
1Moderna, Inc., Cambridge, MA, USA, 2Aetion Iberia, S.L., Barcelona, Spain, 3Aetion, Inc., New York, NY, USA
1Moderna, Inc., Cambridge, MA, USA, 2Aetion Iberia, S.L., Barcelona, Spain, 3Aetion, Inc., New York, NY, USA
OBJECTIVES: Chronic conditions may contribute to the increased risk of severe Respiratory Syncytial Virus (RSV) outcomes, but data quantifying these effects in younger adults remain limited. Furthermore, the impact of RSV among Medicaid-enrolled adults, a socioeconomically vulnerable population, is not well understood. This study aimed to characterize the prevalence of chronic conditions among younger Medicaid beneficiaries with medically attended RSV (MA-RSV), defined as an ICD-10 coded RSV diagnoses associated with healthcare visits. Additionally, the association between chronic conditions and severe RSV outcomes (hospitalization, ICU admission, or mechanical ventilation) was also evaluated.
METHODS: Adults aged 18-59 years with MA-RSV (July 2022-June 2023) were identified from the MarketScan Medicaid database. Continuous enrollment ≥ 365 days before diagnosis was required to assess pre-existing chronic conditions. Severe outcomes within 30 days of diagnosis were analyzed using multivariable generalized linear models, adjusting for demographics and chronic conditions to estimate adjusted relative risks (aRRs).
RESULTS: Among 2,065 MA-RSV patients, 76.2% had at least one chronic condition (17.9% with one, 32.2% with two-to-three, and 26.1% with four or more). The most prevalent conditions were chronic respiratory disease (52.0%), cardiovascular disease (45.1%), and immunocompromised conditions (41.5%). Overall, 24.9% patients had at least one severe outcome. Chronic conditions were significantly associated with higher risks of severe outcomes, with the highest aRR of 13.9 (95% CI: 8.4-23.0) in those with 4+ conditions. The risk of severe outcomes associated with chronic conditions was significant across age spectrum [aRR: 5.6 (95% CI: 2.8-11.1) at age 18; aRR: 11.3 (95% CI: 3.6-35.3) at age 59].
CONCLUSIONS: Chronic conditions substantially increase the risk of severe RSV outcomes, even among younger adults. The consistently high risks across this age group underscore the critical need for targeted interventions, including the development and deployment of RSV vaccines to reduce severe outcomes.
METHODS: Adults aged 18-59 years with MA-RSV (July 2022-June 2023) were identified from the MarketScan Medicaid database. Continuous enrollment ≥ 365 days before diagnosis was required to assess pre-existing chronic conditions. Severe outcomes within 30 days of diagnosis were analyzed using multivariable generalized linear models, adjusting for demographics and chronic conditions to estimate adjusted relative risks (aRRs).
RESULTS: Among 2,065 MA-RSV patients, 76.2% had at least one chronic condition (17.9% with one, 32.2% with two-to-three, and 26.1% with four or more). The most prevalent conditions were chronic respiratory disease (52.0%), cardiovascular disease (45.1%), and immunocompromised conditions (41.5%). Overall, 24.9% patients had at least one severe outcome. Chronic conditions were significantly associated with higher risks of severe outcomes, with the highest aRR of 13.9 (95% CI: 8.4-23.0) in those with 4+ conditions. The risk of severe outcomes associated with chronic conditions was significant across age spectrum [aRR: 5.6 (95% CI: 2.8-11.1) at age 18; aRR: 11.3 (95% CI: 3.6-35.3) at age 59].
CONCLUSIONS: Chronic conditions substantially increase the risk of severe RSV outcomes, even among younger adults. The consistently high risks across this age group underscore the critical need for targeted interventions, including the development and deployment of RSV vaccines to reduce severe outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH119
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Infectious Disease (non-vaccine)