Giannini Fiona, Hogan Alexandra B, Cameron Ewan, Le Huong, Minney-Smith Cara, Richmond Peter, Blyth Christopher C, Glass Kathryn, Moore Hannah C
The Kids Research Institute Australia, University of Western Australia, 15 Hospital Ave, Nedlands, WA 6009, Australia; National Centre for Epidemiology and Population Health, The Australian National University, 62 Mills Rd, The Australian National University, Acton, ACT, 2601, Australia.
School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney NSW 2052 Australia.
Vaccine. 2025 May 22;56:127155. doi: 10.1016/j.vaccine.2025.127155. Epub 2025 May 7.
The Australian Therapeutic Goods Administration approved the use of nirsevimab, a long-acting monoclonal antibody for the prevention of Respiratory Syncytial Virus (RSV), in November 2023. Western Australia (WA) implemented a combination of nirsevimab administration strategies designed to protect all infants starting in April 2024, before the epidemic season. We developed a dynamic transmission model to predict the impact of WA's RSV immunisation program on infant hospitalisations.
Our model is calibrated to monthly-aggregated hospitalisation data of children aged <5 years in temperate WA from 2015 to 2019. The model was extended to capture administration of nirsevimab at varying coverage levels for different age and risk groups, using efficacy trial data to parameterise the simulation of nirsevimab protection at a population-level from the time of administration.
We predict that under the observed coverage levels, approximately one-third of RSV-hospitalisations across temperate WA in under 2-year-olds will be averted by the nirsevimab infant immunisation program. We show that immunisation of newborns between April and September has the largest impact, potentially averting up to 28 % of RSV-hospitalisations in under 2-year-olds. Extending the program to immunise all children in their second year, could avert approximately half of RSV-hospitalisations of young children in temperate WA.
A comprehensive seasonal infant immunisation program using nirsevimab, such as the one implemented in WA, can greatly reduce the RSV-hospitalisation burden in young children, with immunisation at birth prior to and during the yearly epidemic having the most impact on hospitalisations.
2023年11月，澳大利亚治疗用品管理局批准使用nirsevimab（一种用于预防呼吸道合胞病毒（RSV）的长效单克隆抗体）。西澳大利亚州（WA）实施了一系列nirsevimab给药策略组合，旨在从2024年4月疫情季节开始前保护所有婴儿。我们开发了一个动态传播模型，以预测西澳大利亚州RSV免疫计划对婴儿住院率的影响。
我们的模型根据2015年至2019年西澳大利亚州温带地区5岁以下儿童的月度汇总住院数据进行校准。该模型进行了扩展，以捕捉不同年龄和风险组在不同覆盖水平下nirsevimab的给药情况，使用疗效试验数据对从给药时起人群水平上nirsevimab保护的模拟进行参数化。
我们预测，在观察到的覆盖水平下，西澳大利亚州温带地区2岁以下儿童中约三分之一的RSV住院病例将通过nirsevimab婴儿免疫计划得以避免。我们表明，4月至9月对新生儿进行免疫接种的影响最大，有可能避免2岁以下儿童中高达28%的RSV住院病例。将该计划扩展至对所有2岁儿童进行免疫接种，可避免西澳大利亚州温带地区幼儿约一半的RSV住院病例。
使用nirsevimab的全面季节性婴儿免疫计划，如西澳大利亚州实施的计划，可大幅减轻幼儿的RSV住院负担，在每年疫情之前和期间对新生儿进行免疫接种对住院率的影响最大。
