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RSV Vaccination Among Older Adults With Chronic Conditions Could be Cost Effective

Adults with underlying medical conditions, resulting in an increased risk of respiratory syncytial virus disease are more likely to be cost-effective than general age-based strategies.

Researchers created a model to evaluate the cost-effectiveness of vaccine programs in different age and medical risk groups for respiratory syncytial virus (RSV). Published in the Canadian Medical Association Journal, targeting vaccination programs to individuals with preexisting health conditions could be a cost-effective solution to reducing RSV infection.1

Illustration of Respiratory Syncytial Virus or RSV - Image credit: Peter Hansen | stock.adobe.com

Image credit: Peter Hansen | stock.adobe.com

“Cost-effectiveness analysis can be used to quantify the costs and benefits of potential vaccination programs for RSV. These analyses generate an incremental cost-effectiveness ratio (ICER) that estimates the additional cost for 1 additional unit of health outcome for an intervention relative to a comparator and helps assess value for money,” said the study authors in a news release.2

RSV infection is known to cause severe illness in older adults, which can result in hospitalization and/or death among individuals with underlying health conditions.1 Those at higher risk are typically 75 years and older with commodities like pulmonary and cardiovascular conditions.3 Following the approval of recombinant, AS01E adjuvanted vaccine (RSVPreF3) and RSV prefusion F subunit vaccine (RSVpreF), researchers aimed to assess if vaccination campaigns could decrease the incidence in older adults and related health care costs.2

Researchers from Public Health Agency of Canada, Ottawa; Dalla Lana School of Public Health, University of Toronto, Toronto; Faculty of Health Sciences, McMaster University, Hamilton; School of Epidemiology and Public Health, University of Ottawa, Ottawa; Public Health Ontario, Toronto; and Institut national de santé publique du Québec, Québec, conducted a study that assessed the cost effectiveness of RSV vaccination programs among individuals that resided in Canada, aged 50 years and older. The study authors noted that they assessed a combination of age-only, medical risk-only and age-plus vaccination strategies.1,2

The model surveyed a multi-age closed population of 100,000 individuals over 3 years from 3 full RSV seasons. The study authors noted that individuals were characterized by the presence or absence of 1 or more chronic medical condition. Additionally, costs were based following hospital admissions for RSV on attributable costs credited from a previous retrospective population-based cohort study, along with costs for outpatient cases on estimates for individuals with influenza. The researchers also used RSV burden in adults aged 60 years and older in high-income counties from a previous meta-analysis to evaluate the approach of estimating RSV disease burden.2

“Strategies focused on adults with underlying medical conditions that place them at increased risk of RSV disease are more likely to be cost-effective than general age-based strategies,” Ashleigh Tuite, MD, from the Centre for Immunization Programs at the Public Health Agency of Canada and the Dalla Lana School of Public Health at the University of Toronto in Toronto, Ontario, said in a news release. “We found that vaccination of older adults may be less costly and more effective than no vaccination and that vaccinating people aged 70 years and older with chronic medical conditions is likely to be cost-effective based on commonly used cost-effectiveness thresholds.”1

The findings suggest that adults with underlying medical conditions, resulting in an increased risk of RSV disease are more likely to be cost-effective than general age-based strategies. The study authors noted that broadening vaccination programs across age groups in populations with higher risk of disease and higher health care expenses could be cost effective.1,2

REFERENCES
1. RSV vaccination in older adults with health conditions is cost-effective. EurekAlert!. News release. September 9, 2024. Accessed September 25, 2024. https://www.eurekalert.org/news-releases/1056598.
2. Respiratory syncytial virus vaccination strategies for older Canadian adults: a cost–utility analysis. Canadian Medical Association Journal. September 9, 2024. Accessed September 25, 2024. https://www.cmaj.ca/content/196/29/E989#msdynttrid=S8BhOWQCUcD7KVgtjBWqHVV78XtWjYNNUEg3ox3SP_A.
3. Respiratory syncytial virus vaccination in older adults. Canadian Medical Association Journal. September 9, 2024. Accessed September 25, 2024. https://www.cmaj.ca/content/196/29/E1011#msdynttrid=z1yz6oXSKkrVjIxsLEqWswp4U3rQOJfo9bM4fcOQ5uo.
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