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呼吸道合胞病毒前体融合蛋白疫苗接种对减轻婴幼儿和老年人呼吸道合胞病毒负担的影响。

Impact of RSVpreF vaccination on reducing the burden of respiratory syncytial virus in infants and older adults.

作者信息

Du Zhanwei, Pandey Abhishek, Moghadas Seyed M, Bai Yuan, Wang Lin, Matrajt Laura, Singer Burton H, Galvani Alison P

机构信息

WHO Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.

School of Medicine, Yunnan University, Kunming, Yunnan, China.

出版信息

Nat Med. 2025 Feb;31(2):647-652. doi: 10.1038/s41591-024-03431-7. Epub 2025 Jan 9.

Abstract

Respiratory syncytial virus (RSV) causes a substantial health burden among infants and older adults. Prefusion F protein-based vaccines have shown high efficacy against RSV disease in clinical trials, offering promise for mitigating this burden through maternal and older adult immunization. Employing an individual-based model, we evaluated the impact of RSV vaccination on hospitalizations and deaths in 13 high-income countries, assuming that the vaccine does not prevent infection or transmission. Using country-specific vaccine uptake rates for seasonal influenza, we found that vaccination of older adults would prevent hospitalizations by a median of 35-64% across the countries studied here. Vaccination of pregnant women could avert infant hospitalizations by 5-50%. Reductions in RSV-related mortality mirrored those estimated for hospitalizations. While substantial hospitalization costs could be averted, the impact of vaccination depends critically on uptake rates. Enhancing uptake and accessibility is crucial for maximizing the real-world impact of vaccination on reducing RSV burden among vulnerable populations.

摘要

呼吸道合胞病毒(RSV)在婴儿和老年人中造成了沉重的健康负担。基于融合前F蛋白的疫苗在临床试验中已显示出对RSV疾病的高效性,有望通过对孕产妇和老年人进行免疫接种来减轻这一负担。我们采用基于个体的模型,评估了RSV疫苗接种对13个高收入国家住院率和死亡率的影响,假设该疫苗不能预防感染或传播。利用各国季节性流感疫苗的接种率,我们发现,在此处研究的各国中,老年人接种疫苗可使住院率中位数降低35%至64%。孕妇接种疫苗可避免5%至50%的婴儿住院。RSV相关死亡率的降低与住院率的估计降低情况相似。虽然可以避免大量的住院费用,但疫苗接种的影响关键取决于接种率。提高接种率和可及性对于最大化疫苗接种在减轻弱势群体RSV负担方面的实际影响至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b920/11835734/387c5c5f52bf/41591_2024_3431_Fig1_HTML.jpg

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