The potential public health impact of new immunization strategies for the prevention of RSV in children in Panama.

OBJECTIVE

New prophylaxis to reduce the burden of respiratory syncytial virus (RSV) disease are available, including a long-acting monoclonal antibody (nirsevimab) and maternal immunization with an RSV prefusion F protein vaccine (RSVpreF). We compared the potential public health impact of these strategies when implemented in Panama from the payer perspective.

METHODS

A static model evaluated the use of year-round nirsevimab with/without catch-up, seasonal nirsevimab with catch-up, and RSVpreF in a birth cohort. Health, cost, quality-of-life outcomes, and the number needed to immunize (NNI) were compared to the current standard of care, followed by an indirect comparison of nirsevimab and RSVpreF.

RESULTS

Seasonal nirsevimab with catch-up would be the most effective strategy as it would prevent 62% RSV-associated lower respiratory tract disease cases compared to RSVpreF, followed by year-round nirsevimab with catch-up that would prevent 46% of cases. Each of the nirsevimab strategies would have a greater impact on all outcomes compared to RSVpreF. The NNI to prevent an RSV infection and death was lower for the nirsevimab strategies compared to RSVpreF.

CONCLUSION

RSV immunization strategies would significantly reduce the disease burden in Panama. Nirsevimab would have a greater public health impact than RSVpreF due to its sustained efficacy and protection regardless of gestational age.