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Updated: Sep 14, 2025
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An Improved and High Throughput Respiratory Syncytial Virus RSV Micro-neutralization Assay
Published on: January 26, 2019
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Optimizing Timing for Respiratory Syncytial Virus Prevention Interventions for Infants
Danielle Nguyen1, Haeseon Lee1, Andrew T Pavia2
1Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City.
JAMA Network Open
|July 23, 2025
Summary
Maternal vaccine (MV) and nirsevimab are recommended for infant respiratory syncytial virus (RSV) protection. MV is cost-effective for RSV prevention in infants born early in the season, while nirsevimab is cost-effective only for the earliest months.
Area of Science:
- Public Health
- Health Economics
- Pediatrics
Background:
- The Centers for Disease Control and Prevention recommend maternal vaccine (MV) or nirsevimab for infant protection against respiratory syncytial virus (RSV).
- The cost-effectiveness of these interventions may vary based on administration timing, uptake, and efficacy.
Purpose of the Study:
- To evaluate the clinical outcomes and cost-effectiveness of maternal vaccine (MV) and nirsevimab for infant RSV prevention.
- To compare these interventions against no intervention for monthly birth cohorts and the entire RSV season.
Main Methods:
- Economic evaluation using a Markov model from a societal perspective.
- Analysis incorporated a willingness-to-pay threshold of $150,000 per QALY.
- Included infants born in the US during the RSV season (October-February).
Main Results:
- Maternal vaccine (MV) was cost-saving for infants born in October, November, and December, and cost-effective for the combined October-February cohort ($19,562/QALY).
- Nirsevimab was cost-effective compared to MV only for infants born in October ($67,178/QALY) and November ($88,531/QALY).
- MV was projected to avert 7,154 hospitalizations and 12 deaths; nirsevimab was projected to avert 11,893 hospitalizations and 19 deaths during the RSV season.
Conclusions:
- Administering maternal vaccine (MV) during the first four months and throughout the RSV season can be cost-effective.
- Nirsevimab demonstrated cost-effectiveness compared to MV only for infants born in October and November.
- Optimizing intervention use by restricting administration to specific months may be beneficial; further research on transmission dynamics is needed.
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