OBJECTIVES: The burden of respiratory syncytial virus (RSV) disease in older adults (OA) is high, with seasonal peaks in RSV incidence leading to health care system strain. The objective of this study is to estimate the public health impact of implementing the RSVPreF3 OA vaccine for older adults (60 years and older) in Germany.

METHODS: A published Markov model was adapted for medically attended RSV acute respiratory infections (RSV-ARI) in individuals 60 years and older in Germany. RSV-ARI cases were classified into upper or lower respiratory tract disease (URTD/LRTD).

The model considers the average RSV incidence and seasonality over six seasons (2013/14 to 2018/19), from a German surveillance system. The RSV-related burden of disease, utility loss and health care costs were based on a claims data study and the results of a prospective study. Vaccine efficacy and waning against RSV-ARI (peak: 74.17%, waning: 2,26%/month) and RSV-LRTD (peak: 88.02%, waning: 2,10%/month) were derived from clinical trial data.

A baseline scenario without vaccination was compared with a RSVPreF3 OA immunization programme reaching the same coverage as flu vaccines, at 43.3%. Relevant outcomes compared include RSV cases, health care resource use, deaths, quality adjusted life-years (QALY) loss and costs (discounted at 3%) over a three-year time horizon.

RESULTS: The model estimates that the RSVPreF3 OA vaccine, compared with no vaccination, leads to preventing 39,462 (7.0%) RSV-URTD and 223,505 (25.9%) RSV-LRTD medically-attended cases, leading to fewer hospitalizations (-53,697), intensive care admissions (-13,986) and deaths (-8,596) over three years. The QALYs gained with the vaccination strategy amount to 57,582, leading to an incremental cost-effectiveness ratio of 39,252 €/QALY.

CONCLUSIONS: RSVPreF3 OA vaccine is one of the only available prevention strategies for RSV infections and can lead to a significant reduction of cases and burden on the healthcare system.

Funding: GSK (GSK study identifier: VEO-000578).