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Published on: January 26, 2019
Cost-Effectiveness of Maternal Vaccination to Prevent Respiratory Syncytial Virus Illness
David W Hutton1, Lisa A Prosser1,2, Angela M Rose2
1Department of Health Management and Policy, School of Public Health.
Insights
Maternal vaccination against respiratory syncytial virus (RSV) using RSV bivalent prefusion F maternal vaccine (RSVpreF) can be cost-effective for preventing infant hospitalizations. Seasonal administration before the RSV season offers the best value, saving lives and healthcare costs.
Area of Science:
- Public Health
- Vaccinology
- Health Economics
Background:
- Respiratory syncytial virus (RSV) is a leading cause of infant hospitalizations in the US.
- A new maternal vaccine, RSV bivalent prefusion F maternal vaccine (RSVpreF), is now available to protect infants.
- The FDA approved and CDC recommended RSVpreF for pregnant individuals.
Purpose of the Study:
- To evaluate the health benefits of maternal RSVpreF vaccination in the US.
- To assess the cost-effectiveness of maternal RSVpreF vaccination from a societal perspective.
Main Methods:
- A simulation model of RSV infection in the annual US birth cohort was developed.
- The model incorporated data from peer-reviewed literature, FDA records, and surveillance databases.
- Health outcomes and costs were analyzed over a 1-year timeframe with a 3% discount rate.
Main Results:
- Maternal RSVpreF vaccination could prevent over 7,500 infant hospitalizations annually.
- Year-round vaccination yielded a cost of $396,280 per QALY gained.
- Seasonal vaccination (September-January) reduced the cost to $163,513 per QALY gained.
Conclusions:
- Seasonal maternal RSV vaccination is a potentially cost-effective strategy.
- Administering the vaccine just before or at the start of the RSV season maximizes cost-effectiveness.
- This approach can significantly reduce the burden of RSV lower respiratory tract infections in infants.
Background And Objectives:
Respiratory syncytial virus (RSV) commonly causes hospitalization among US infants. A maternal vaccine preventing RSV in infants, RSV bivalent prefusion F maternal vaccine (RSVpreF), was approved by the US Food and Drug Administration and recommended by the Advisory Committee on Immunization Practices. Our objective was to evaluate the health benefits and cost-effectiveness of vaccinating pregnant persons in the United States using RSVpreF.
Methods:
We simulated RSV infection and disease with and without seasonal RSVpreF vaccination in half of the pregnant persons in the annual US birth cohort during weeks 32 through 36 of gestation. Model inputs came from peer-reviewed literature, Food and Drug Administration records, and epidemiological surveillance databases. The results are reported using a societal perspective in 2022 US dollars for a 1-year time frame, discounting future health outcomes and costs at 3%. Sensitivity and scenario analyses were performed.
Results:
Year-round maternal vaccination with RSVpreF would prevent 45 693 outpatient visits, 15 866 ED visits, and 7571 hospitalizations among infants each year. Vaccination had a societal incremental cost of $396 280 per quality-adjusted life-year (QALY) saved. Vaccination from September through January cost $163 513 per QALY saved. The most influential inputs were QALYs lost from RSV disease, the cost of the vaccine, and RSV-associated hospitalization costs; changes in these inputs yielded outcomes ranging from cost-saving to $800 000 per QALY saved.
Conclusions:
Seasonal maternal RSV vaccination designed to prevent RSV lower respiratory tract infection in infants may be cost-effective, particularly if administered to pregnant persons immediately before or at the beginning of the RSV season.
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