Clinical and economic outcomes associated with respiratory syncytial virus vaccination in older adults in the United States

作者：William L. Herring, Yuanhui Zhang, Vivek Shinde, Jeffrey J. Stoddard, Sandra E. Talbird, Brian Rosen · 发表于：Vaccine · 年份：2021 · DOI：10.1016/j.vaccine.2021.12.002 · 被引用次数：43 · 研究领域：Respiratory viral infections research、COVID-19 Clinical Research Studies、Cystic Fibrosis Research Advances

BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of lower respiratory infections and hospitalizations among older adults. We aimed to estimate the potential clinical benefits and economic value of RSV vaccination of older adults in the United States (US). METHODS: We developed an economic model using a decision-tree framework to capture outcomes associated with RSV infections in US adults aged ≥ 60 years occurring during one RSV season for a hypothetical vaccine versus no vaccine. Two co-base-case epidemiology sources were selected from a targeted review of the US literature: a landmark study capturing all RSV infections and a contemporary study reporting medically attended RSV that also distinguishes mild from moderate-to-severe disease. Both base-case analyses used recent data on mortality risk in the year after RSV hospitalizations. Direct medical costs and quality-adjusted life-years (QALYs) lost per case were obtained from the literature and publicly available sources. Model outcomes included the population-level clinical and economic RSV disease burden among older adults, potential vaccine-avoidable disease burden, and the potential value-based price of a vaccine from a third-party payer perspective. RESULTS: Our two base-case analyses estimated that a vaccine with 50% efficacy and coverage matching that of influenza vaccination would prevent 43,700-81,500 RSV hospitalizations and 8,000-14,900 RSV-attributable deaths per RSV season, resulting in 1,800...