OBJECTIVES: Certain comorbidities are associated with an increased risk of severe respiratory syncytial virus (RSV) disease in adults. While previous modeling has estimated substantial public health benefits of adjuvanted RSVPreF3 vaccination among adults ≥60 years of age (YOA) and those at increased risk 50-59 YOA, this analysis estimated the potential public health impact of adjuvanted RSVPreF3 vaccination in US adults at increased risk 18-49 YOA.
METHODS: A Markov model estimated outcomes over a 5-year time horizon for US adults 18-49 YOA at increased risk of severe RSV disease. Scenarios included adults with diabetes (N=5,249,761) and asthma (N=9,956,842). Scientific literature and public data sources informed model inputs. Vaccine efficacy was based on phase 3 clinical trial data. Estimated public health outcomes (e.g., RSV cases, RSV-related healthcare use, and RSV-related deaths) were compared between simulations with and without one-time adjuvanted RSVPreF3 vaccination, assuming the same vaccination uptake as for influenza vaccination (32.8%).
RESULTS: One-time adjuvanted RSVPreF3 vaccination in adults 18-49 YOA with diabetes was projected to avoid 124,666 RSV lower respiratory tract disease (LRTD) cases, 73,822 RSV-related outpatient visits, 5,364 hospitalizations, and 169 deaths over the 5-year time horizon. For adults 18-49 YOA with asthma, vaccination was projected to avoid 205,974 RSV-LRTD cases, 121,085 RSV-related outpatient visits, 1,806 hospitalizations, and 57 deaths. There were 5,752 (diabetes) and 6,492 (asthma) fewer quality-adjusted life year losses with adjuvanted RSVPreF3 vaccination. The number needed to vaccinate to avoid one RSV-LRTD case, RSV-related outpatient visit, or RSV-related hospitalization was 14, 23, and 321, respectively, for adults with diabetes and 16, 27, and 1,808, respectively, for adults with asthma.
CONCLUSIONS: Results suggest substantial potential public health benefits of adjuvanted RSVPreF3 vaccination in adults 18-49 YOA at increased risk of severe RSV disease. Future analyses may further inform the potential value of adjuvanted RSVPreF3 vaccination in this population.
