(372) Cost-Effectiveness of Maternal RSV Vaccination in Preventing RSV-Related Hospitalizations in Infants

Respiratory syncytial virus (RSV) is a leading cause of hospitalization among infants under 6 months of age. Maternal vaccination offers passive protection to neonates through vaccine-induced antibodies crossing the placenta. This study evaluates the cost-effectiveness of maternal RSV vaccination compared to no vaccination in preventing RSV-related hospitalizations in infants in the United States.


Study Design:

A decision-analytic model was developed to evaluate outcomes in a theoretical U.S. birth cohort of 3,664,292 individuals, the estimated number of annual live births in the United States. The model incorporated neonatal outcomes including stillbirth, RSV-related hospitalizations, infant death, and development of asthma by 6 years of age. Input values for probabilities, costs, and utilities were derived from literature, and quality-adjusted life years (QALYs) were discounted at an annual rate of 3%. An incremental cost-effectiveness ratio (ICER) of less than $100,000 per QALY was considered cost effective.


Results:

Maternal RSV vaccination prevented 63,435 RSV infections and reduced RSV-related hospitalizations by 45,363 cases in our theoretical cohort (Table 1). Maternal RSV vaccination also reduced infant death by 100 cases and asthma diagnosis by age 6 by 13,469 cases. Vaccine-induced maternal antibodies was the dominant strategy as it led to an additional 113,522 QALYs with a difference in cost of $124,146,213 resulting in an ICER of $1,093 per QALY.


Conclusion:

Maternal RSV vaccination is a cost-effective strategy for preventing and reducing RSV-related morbidities in infants, even when accounting for the cost of vaccination. Incorporating RSV vaccination into routine prenatal care and ensuring all pregnant people are aware of its protective benefits are key to achieving better neonatal health outcomes.