Statutory reporting data-driven analysis in Saxony, Germany, to guide RSV vaccination recommendations
Introduction: Respiratory syncytial virus (RSV) infection poses a high risk to infants in their first months of life. Administering RSV-specific monoclonal antibodies before or during the season can significantly reduce the risk of illness. Additionally, transfer of immunity through prenatal immuniz...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-03-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971224007999 |
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| Summary: | Introduction: Respiratory syncytial virus (RSV) infection poses a high risk to infants in their first months of life. Administering RSV-specific monoclonal antibodies before or during the season can significantly reduce the risk of illness. Additionally, transfer of immunity through prenatal immunization of pregnant women, which is now possible with a vaccine licensed in Europe, may decrease the burden of disease.Although the individual benefits of RSV vaccination are well-documented, the epidemiological effects of passive immune transfer from mother to the newborn cannot be predicted with certainty due to a lack of epidemiological data in Germany. Until 2023, only the federal state of Saxony had a reporting obligation for RSV infections.The aim of this study was to model the epidemiological effects based on the notification data for children in their first year of life. Methods: The study analyzed anonymized RSV notification data collected between 2016 and 2023 in Saxony, Germany.The incidences of RSV infection and severe RSV infection (defined by hospitalization) were determined. Vaccine effectiveness and numbers needed to vaccinate (NNV) were calculated using data recently published by Kampmann et al.The impact of the neonatal age and vaccination coverage among pregnant women on RSV infections and RSV-associated hospitalizations was estimated. Additionally, cost-effectiveness was calculated using data from the German and Austrian DRG reimbursement systems. Results: The incidence of RSV infections in the first year of life ranged from 1,781 to 4,304 per 100,000, for severe RSV infections from 718 to 2,061. Hospitalization rates were highest in the first month of life (73% of notified infections). Burden of disease was the highest in the second to fourth months of life (incidences: 4,599, 5,348 and 4,718, respectively). In 2020 there were considerably fewer cases due to pandemic contact restrictions.Calculated on a monthly basis, complete immunization of all pregnant women would prevent between 401 and 2,618 infections in infants in their first six months of life (median NNV 54, range 45-303) as well as up to 2,252 severe RSV infections (median NNV 84, range 50-291).Cost-effectiveness of maternal vaccination is expected to be achieved at coverage rates >20% of pregnant women, given the current price of one RSV vaccine dose in Germany. Conclusion: The registry data from Saxony, Germany, document a substantial burden of RSV disease in infants during their first year of life.Consistent vaccination of pregnant women against RSV can prevent a significant proportion of infections in their infants, including severe cases requiring hospitalization.From an efficacy point of view, it seems appropriate to include maternal RSV vaccination in state vaccination programs. |
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| ISSN: | 1201-9712 |