BACKGROUND: RSV is an important cause of lower respiratory tract disease (LRTD) in older adults and may cause substantial morbidity, mortality, and economic disruption. The Joint Committee on Vaccination and Immunisation (JCVI) advised introducing a one-off RSV vaccine into the national immunisation schedule for adults aged 75-80. The potential impact of mRNA-1345, an RSV vaccine, was explored for UK adults aged =65, aligned with current influenza vaccine recommendations.
METHODS: A decision-analytic model (Figure 1) was developed to estimate the clinical impact of mRNA-1345 compared with no vaccine over two-years from a UK perspective. Trial data (Wilson et al 2023) was used to populate mRNA-1345 efficacy in preventing RSV-LRTD, RSV-acute respiratory disease (ARD), and RSV-hospitalizations, projected over two-years. Table 1 shows the key inputs. Outcomes included RSV-case numbers, RSV-LRTD hospitalisations, numbers needed to vaccinate (NNV) to prevent these outcomes, incremental life years and quality-adjusted life-years (QALYs).
RESULTS: When targeting UK adults aged =65, compared to no vaccination, administering mRNA-1345 could result in a 33.8%, 38.6%, and 52.0% reduction in cases of RSV-ARD, RSV-LRTD, and deaths respectively. A reduction of 29,412 RSV-LRTD hospitalisations (52.0%) were estimated. Vaccination was estimated to save 95,556 QALYs and 121,885 life-years over two-years for a total population of 12,537,031. The NNV to prevent one RSV-LRTD case, one RSV hospitalisation and one death was 57, 426 and 755, respectively.
CONCLUSIONS: In UK adults aged =65, implementing mRNA-1345 could have a significant impact on reducing RSV-related morbidity and mortality, and as a result reduce healthcare resource use and improve population quality of life.