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Updated: Nov 30, 2025
An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Evaluating the next generation of RSV intervention strategies: a mathematical modelling study and cost-effectiveness
David Hodgson1,2,3,4, Richard Pebody5, Jasmina Panovska-Griffiths6,7,8
1Centre for Mathematics, Physics and Engineering in the Life Sciences and Experimental Biology, University College London, London, UK. david.hodgson@lshtm.ac.uk.
Background:
With a suite of promising new RSV prophylactics on the horizon, including long-acting monoclonal antibodies and new vaccines, it is likely that one or more of these will replace the current monoclonal Palivizumab programme. However, choosing the optimal intervention programme will require balancing the costs of the programmes with the health benefits accrued.
Methods:
To compare the next generation of RSV prophylactics, we integrated a novel transmission model with an economic analysis. We estimated key epidemiological parameters by calibrating the model to 7 years of historical epidemiological data using a Bayesian approach. We determined the cost-effective and affordable maximum purchase price for a comprehensive suite of intervention programmes.
Findings:
Our transmission model suggests that maternal protection of infants is seasonal, with 38-62% of infants born with protection against RSV. Our economic analysis found that to cost-effectively and affordably replace the current monoclonal antibody Palivizumab programme with long-acting monoclonal antibodies, the purchase price per dose would have to be less than around £4350 but dropping to £200 for vaccinated heightened risk infants or £90 for all infants. A seasonal maternal vaccine would have to be priced less than £85 to be cost-effective and affordable. While vaccinating pre-school and school-age children is likely not cost-effective relative to elderly vaccination programmes, vaccinating the elderly is not likely to be affordable. Conversely, vaccinating infants at 2 months seasonally would be cost-effective and affordable if priced less than £80.
Conclusions:
In a setting with seasonal RSV epidemiology, maternal protection conferred to newborns is also seasonal, an assumption not previously incorporated in transmission models of RSV. For a country with seasonal RSV dynamics like England, seasonal programmes rather than year-round intervention programmes are always optimal.
Insights
New respiratory syncytial virus (RSV) preventatives, like maternal vaccines and infant immunizations, are cost-effective. Seasonal RSV interventions are optimal for countries with seasonal RSV epidemiology, like England.
Area of Science:
- Epidemiology
- Health Economics
- Infectious Disease Prevention
Background:
- New respiratory syncytial virus (RSV) prophylactics, including monoclonal antibodies and vaccines, are emerging.
- These may replace the current Palivizumab program.
- Optimal program selection requires balancing costs and health benefits.
Purpose of the Study:
- To compare next-generation RSV prophylactics using a novel transmission model and economic analysis.
- To estimate epidemiological parameters by calibrating the model to historical data.
- To determine cost-effective and affordable pricing for intervention programs.
Main Methods:
- Integrated a novel transmission model with economic analysis.
- Calibrated the model to 7 years of historical RSV epidemiological data using Bayesian methods.
- Determined cost-effective and affordable maximum purchase prices for various intervention strategies.
Main Results:
- Maternal protection against RSV is seasonal, with 38-62% of infants born protected.
- Long-acting monoclonal antibodies require prices <£4350/dose to replace Palivizumab, dropping to £200 (high-risk infants) or £90 (all infants).
- Seasonal maternal vaccines (<£85) and infant vaccinations (<£80) are cost-effective and affordable; elderly vaccination is not likely affordable.
Conclusions:
- Maternal protection of newborns against RSV is seasonal, an assumption not previously modeled.
- Seasonal RSV intervention programs are optimal for countries with seasonal RSV epidemiology, such as England.
- Infant vaccination at 2 months seasonally is a cost-effective and affordable strategy.
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