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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
Modelling the epidemiological impact of maternal respiratory syncytial virus (RSV) vaccination in Australia
Allen L Nazareno1, Anthony T Newall2, David J Muscatello2
1School of Population Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia; Institute of Mathematical Sciences, College of Arts and Sciences, University of the Philippines Los Baños, Laguna, Philippines.
Insights
A maternal respiratory syncytial virus (RSV) vaccine program in Australia could halve infant hospitalizations. This vaccination strategy significantly reduces RSV infections in infants under six months, offering substantial public health benefits.
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Respiratory syncytial virus (RSV) is a major cause of infant respiratory illness.
- A maternal RSV vaccine for infant protection is now approved in Australia.
- Population-level benefits of a maternal RSV vaccination program require estimation.
Purpose of the Study:
- To estimate the population benefits of a future year-round maternal RSV vaccination program in Australia.
- To quantify prevented RSV infections and hospitalizations in infants and the wider population.
- To assess the impact of vaccine efficacy, coverage, and duration on outcomes.
Main Methods:
- An age-structured compartmental model simulated RSV transmission in Australia.
- The model incorporated mother-infant interactions for realistic herd effect assessment.
- Annual age-specific RSV infections and hospitalizations were estimated under various vaccine scenarios.
Main Results:
- A 60% reduction in RSV hospitalizations for infants under 3 months and 40% for 3-5-month-olds was predicted with 70% coverage and 6-month protection.
- Direct infant protection from vaccinated mothers was the primary driver of benefits.
- Population-level RSV infection was reduced by approximately 4%, with potential for greater impact with higher coverage or longer protection duration.
Conclusions:
- A year-round maternal RSV vaccination program could halve RSV hospitalizations in infants under 6 months, assuming uptake similar to other maternal vaccines.
- A small herd effect was predicted, with potential for larger benefits under optimistic coverage and duration assumptions.
- Maternal RSV vaccination represents a significant public health intervention for infant respiratory illness prevention.
Background:
Respiratory syncytial virus (RSV) is a leading cause of respiratory illness among infants. A maternal RSV vaccine that protects young infants has recently been approved for registration in Australia. We estimated the population benefits of a future year-round maternal RSV vaccination program in terms of prevented RSV infections and hospitalisations in Australia.
Methods:
We described RSV transmission using an age-structured compartmental model calibrated to Australian aggregated monthly RSV-coded hospitalisations in children aged <5 years. We accounted for mother and infant interactions in the model to capture herd effects more realistically. Using the model, we estimated the annual age-specific RSV infections and hospitalisations prevented for a range of assumptions for vaccine efficacy, coverage, and durability to estimate the future impact of year-round maternal RSV vaccination on infants and the wider population.
Results:
Assuming base case vaccine efficacy, 6 months duration of protection and 70% coverage, RSV hospitalisations were predicted to fall by 60% (from 3.0 to 1.2 per 100 persons) in infants aged <3 months and 40% (from 1.9 to 1.1 per 100 persons) in 3-5-month-olds. These benefits were primarily due to direct protection to infants of vaccinated mothers. This vaccine program was predicted to reduce the population-level RSV infection by about 4%. Coverage and duration assumptions were influential, with higher coverage leading to larger declines in infants <6 months, and increased duration of protection leading to additional declines in infection and hospitalisation risk in older infants aged 6-8 months.
Conclusions:
With vaccine uptake similar to that achieved for other maternal vaccines in Australia, a year-round RSV maternal vaccination program is predicted to approximately halve the number of RSV hospitalisations in infants younger than 6 months. There was a small herd effect predicted in the base case but potential for larger benefits if vaccine coverage or the duration of protection exceeds base case assumptions.
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