OBJECTIVES: The burden of respiratory syncytial virus (RSV) is substantial among older adults (OA), with previous research estimating 177,525 RSV-related hospitalizations and 14,000 RSV-related deaths each year in the US. This study estimates the public health impact of vaccinating US adults aged ≥60 years with a single dose of adjuvanted RSV prefusion F protein vaccine RSVPreF3 OA. METHODS: A Markov-cohort model with a 1-year time horizon was developed to compare health outcomes for scenarios with and without RSV vaccination, assuming the same vaccination coverage rates as for the influenza vaccines in the 2021-2022 season (52.4% among 60–64-year-olds, 73.9% among ≥65-year-olds). Population estimates, RSV epidemiology, and health care resource use inputs were obtained from standard US sources and published literature. Vaccine efficacy and waning rates were estimated from the AReSVi-006 phase 3 clinical trial. Sensitivity analyses were performed to test parameter uncertainty.
RESULTS: Without vaccination, RSV results in an estimated 3,031,750 symptomatic infections, 171,415 hospitalizations, and 13,919 deaths each year among US adults aged ≥60 years (n=81,001,651), with considerable burden observed across all age groups. Vaccinating 55,282,554 of these older adults is estimated to prevent 1,277,725 symptomatic RSV infections, including 673,835 cases of RSV lower respiratory tract disease each year. Vaccination is also expected to avoid 496,076 medically attended RSV cases, 94,984 hospitalizations, 23,278 emergency department visits, 87,293 pneumonia complications, 414,668 antibiotic prescriptions, and 7,743 deaths annually. Numbers needed to vaccinate to avoid one symptomatic RSV infection, RSV-related hospitalization, and RSV-related death are 43, 582 and 7,139, respectively. Results were consistent across sensitivity analyses.
CONCLUSION: Vaccinating adults aged ≥60 years in the US with the adjuvanted RSVPreF3 OA vaccine is expected to have a significant public health impact by reducing RSV morbidity and mortality. Patient and health care provider education on RSV disease and vaccines will be important to support older adult RSV vaccination.
