OBJECTIVES: Vaccines that provide a high degree of protection against RSV-induced disease have been available since 2023. The Dutch Health Council will advise the Ministry of Health on a vaccination program covering older adults in the Netherlands in 2024. Here, we assess the clinical benefits of RSV vaccination.

METHODS: A static decision-tree model was designed to simulate RSV epidemiology in individuals aged ≥60 years. The model was calibrated to reflect the Dutch burden of disease and population demographics. The clinical benefits of an RSV vaccination program were assessed under different scenarios, including various age groups and vaccination coverages. The model assumed a two-year timeframe with vaccine effectiveness of 66.0% and 81.3% against acute respiratory disease and lower respiratory tract disease (LRTD), respectively, and monthly waning rate of 2.4%, as observed in clinical trials.

RESULTS: In a population of approximately 5 million individuals aged ≥60 years, the model predicted 537,800 symptomatic cases of RSV, of which ~64,500 resulted in LRTD. Specifically, the model predicted ~138,600 cases requiring GP consultations, 8,350 hospitalizations, and 4,094 deaths over a two-year time horizon. The impact of RSV thus places significant pressure on the Dutch healthcare system. A public RSV vaccination program would substantially reduce the burden of RSV disease. For example, 771 deaths and 3129 hospitalizations would be prevented considering a ≥60 years vaccination strategy with 60.0% coverage during the first 2 years after vaccination.

CONCLUSIONS: A broad public RSV vaccination program for individuals aged ≥60 years has the potential to substantially reduce the burden of RSV disease. While some countries only recommend RSV vaccination for the oldest age groups, we show that vaccination will protect a substantial number of adults aged ≥60 years. For optimal implementation and coverage, RSV vaccine recommendations in older adults should be aligned with those for flu and COVID-19 vaccines.