PUBLIC HEALTH AND ECONOMIC IMPACT OF STRATEGIES TO PROTECT INFANTS IN THE US AGAINST RSV
Author(s)
Amy W. Law, PharmD, MS1, Bernard Gonik, MD2, C. Daniel Mullins, PhD3, Erin Quinn, BS4, Mary MacKinnon, BS4, Sarah J. Pugh, PhD, MPH1.
1Pfizer, New York, NY, USA, 2Wayne State University, Detriot, MI, USA, 3University of Maryland Baltimore, Baltimore, MD, USA, 4Avalere Health, Washington, DC, USA.
1Pfizer, New York, NY, USA, 2Wayne State University, Detriot, MI, USA, 3University of Maryland Baltimore, Baltimore, MD, USA, 4Avalere Health, Washington, DC, USA.
OBJECTIVES: Two preventative options are recommended to protect US infants against RSV: RSVpreF maternal vaccine (MV, during 32+0 to 36+6 weeks gestation) or nirsevimab infant monoclonal antibodies (mAb, recommended within 7 days of birth). Utilization studies indicate a lag in mAb administration beyond 7 days, leaving young infants with suboptimal protection. Through a modeling analysis, we quantified the public health and economic impact of strategies to protect US infants throughout their first 6 months of life.
METHODS: A cohort model evaluated outcomes of immunization strategies where infants born during RSV season (N=1,787,838) received either MV or mAb, compared to no intervention. No infants were protected by both interventions. Outcomes included hospitalizations, medical costs, intervention costs, and indirect costs. Effectiveness was based on clinical trial data (MV: 70.5%, mAb: 77.3%) at 150 days. Immunization coverage and timing was obtained from national 2024/25 data (MV: 36.2%; mAb: 39.1%). Scenario analyses evaluated the impact of maximizing mAb and, alternatively, MV uptake to reach 100% coverage (given base case uptake of the other intervention).
RESULTS: During 2024/25, among infants born during RSV season, the immunization strategy prevented 11,923 (52%) RSV hospitalizations, with a total cost of $295 million. The strategy was least effective at protecting infants aged <1 month, reducing hospitalizations among this subgroup by 38%.
Maximizing mAb or MV coverage would reduce hospitalizations by an additional 31% or 33% respectively, compared to base case. Maximizing MV coverage would prevent 20% more hospitalization among infants aged <1 month and would be 9% less costly than maximizing mAb.
CONCLUSIONS: While MV and mAb have demonstrated valuable public health benefits, many infants remain unprotected, including the youngest infants who are most vulnerable against severe RSV. Maximizing coverage via either MV or mAb would be similarly effective, but increasing MV use would protect the most vulnerable infants at a lower cost.
METHODS: A cohort model evaluated outcomes of immunization strategies where infants born during RSV season (N=1,787,838) received either MV or mAb, compared to no intervention. No infants were protected by both interventions. Outcomes included hospitalizations, medical costs, intervention costs, and indirect costs. Effectiveness was based on clinical trial data (MV: 70.5%, mAb: 77.3%) at 150 days. Immunization coverage and timing was obtained from national 2024/25 data (MV: 36.2%; mAb: 39.1%). Scenario analyses evaluated the impact of maximizing mAb and, alternatively, MV uptake to reach 100% coverage (given base case uptake of the other intervention).
RESULTS: During 2024/25, among infants born during RSV season, the immunization strategy prevented 11,923 (52%) RSV hospitalizations, with a total cost of $295 million. The strategy was least effective at protecting infants aged <1 month, reducing hospitalizations among this subgroup by 38%.
Maximizing mAb or MV coverage would reduce hospitalizations by an additional 31% or 33% respectively, compared to base case. Maximizing MV coverage would prevent 20% more hospitalization among infants aged <1 month and would be 9% less costly than maximizing mAb.
CONCLUSIONS: While MV and mAb have demonstrated valuable public health benefits, many infants remain unprotected, including the youngest infants who are most vulnerable against severe RSV. Maximizing coverage via either MV or mAb would be similarly effective, but increasing MV use would protect the most vulnerable infants at a lower cost.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE282
Topic
Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory), Vaccines