Background: Current estimates of the economic burden of respiratory syncytial virus (RSV) are needed for policymakers to evaluate adult RSV vaccination strategies. Methods: A cost-of-illness model was developed to estimate the annual societal burden of RSV in US adults aged ≥60 years. Additional analyses were conducted to estimate the burden of hospitalized RSV in all adults aged 50–59 years and in adults aged 18–49 years with potential RSV risk factors. Results: Among US adults aged ≥60 years, the model estimated 4.0 million annual RSV cases (95% uncertainty interval [UI], 2.7–5.6 million) and an annual economic burden of $6.6 billion (95% UI, $3.1–$12.9 billion; direct medical costs, $2.9 billion; indirect costs, $3.7 billion). The 4% of RSV cases that were hospitalized contributed to 94% of direct medical costs. Additional analyses estimated $422 million in annual hospitalization costs among all adults aged 50–59 years. Among adults aged 18–49 years with RSV risk factors, annual per capita burden was highest among people with congestive heart failure at $51 100 per 1000 people. Discussion: The economic burden of RSV is substantial among adults aged ≥50 years and among adults aged 18–49 years with RSV risk factors, underscoring the need for preventive interventions for these populations.

Meningococcal vaccination is recommended for patients with complement component deficiencies (CDs) in the United States. In this retrospective database study, only 4.6% and 2.2% of patients received MenACWY and MenB vaccination, respectively, within 3 years of CD diagnosis. Thus, meningococcal vaccination rates among patients with CDs need to be improved.

Morbidity and mortality caused by respiratory syncytial virus (RSV) in older adults and those with underlying health conditions can be potentially alleviated through vaccination. To assist vaccine policy decision-makers and payers, we estimated the annual economic burden of RSV-associated cardiorespiratory hospitalizations among insured US adults aged ≥18 y in the Merative MarketScan claims database from September through August of 2017-2018 and 2018-2019. Negative binomial regression models were used to estimate the number of RSV-associated cardiorespiratory hospitalizations using MarketScan-identified cardiorespiratory diagnosis codes in the presence or absence of RSV circulation per weekly laboratory test positivity percentages from the Centers for Disease Control and Prevention. This number was multiplied by mean cardiorespiratory hospitalization costs to estimate total costs for RSV-associated cardiorespiratory hospitalizations. Number and cost for International Classification of Diseases (ICD)-coded RSV hospitalizations were quantified from MarketScan. In 2017-2018 and 2018-2019, respectively, 18,515,878 and 16,462,120 adults with commercial or Medicare supplemental benefits were assessed. In 2017-2018, 301,248 cardiorespiratory hospitalizations were observed; 0.32% had RSV-specific ICD codes, costing $44,916,324, and 5.52% were RSV-associated cardiorespiratory hospitalizations, costing $734,078,602 (95% CI: $460,826,580-$1,103,358,799). In 2018-2019, 215,525 cardiorespiratory hospitalizations were observed; 0.34% had RSV-specific ICD codes, costing $33,053,105, and 3.14% were RSV-associated cardiorespiratory hospitalizations, costing $287,549,472 (95% CI: $173,377,778-$421,884,259). RSV contributes to substantial economic burden of cardiorespiratory hospitalizations among US adults. Modeling excess risk using viral positivity data provides a comprehensive estimation of RSV hospitalization burden and associated costs, compared with relying on ICD diagnosis codes alone.

Background: The clinical and economic burden of respiratory syncytial virus (RSV) is significant; millions of patients seek medical care due to RSV infections each year. Recently approved vaccines offer an important opportunity to reduce this burden in populations that are at high risk due to certain medical conditions or older age. This study evaluates the public health impact and cost-effectiveness of vaccination with mRNA-1345 against RSV in adults. Methods: A static decision-analytic model was developed to estimate the public health impact and cost-effectiveness of vaccinating high-risk adults aged 18-59 years and all adults aged ≥ 60 years in the 5-year period following vaccination against RSV with a single dose of mRNA-1345 in the United States (US). RSV vaccination rates in the analysis were assumed to be equal to 2019-2020 influenza season vaccination rates. Vaccine effectiveness against RSV-related acute respiratory disease and RSV-associated lower respiratory tract infection over time was modeled using nonlinear waning curves that reflect clinical trial data. Results: According to the model, vaccinating the high-risk adult US population aged 18-59 years and all US adults aged ≥ 60 years with mRNA-1345 would avert over 280,000 hospitalizations, 19,000 deaths, and result in about 244,000 quality-adjusted life-years gained compared with an unvaccinated population over a 5-year period. Vaccination costs approximately $23.2 billion and reduces direct and indirect costs by $10.8 billion and $13.3 billion, respectively, resulting in net savings of more than $810 million from a societal perspective, making vaccination with mRNA-1345 in this population cost saving. Conclusions: Vaccination with mRNA-1345 is a cost-saving strategy for the prevention of RSV in high-risk and older US adults and has the potential for substantial public health impact. KEY SUMMARY POINTS: Why carry out this study? (1-2 bullets): The clinical and economic burden of respiratory syncytial virus (RSV) in high-risk and older adults is significant The mRNA-1345 RSV vaccine has been approved in adults aged ≥ 60 years in 2024 and high-risk adults 18-59 years old in 2025, but the potential clinical benefit and cost-effectiveness of RSV vaccination has not been established. What did the study ask?/What was the hypothesis of the study? (1 bullet): The study objective was to examine the public health impact and cost-effectiveness of RSV vaccination with mRNA-1345 compared with no vaccination in high-risk adults aged 18-59 years and all adults aged ≥ 60 years in the United States (US) in the 5-year period following vaccination. What were the study outcomes/conclusions? (1 bullet point): Vaccination with mRNA-1345 results in 280,000 fewer hospitalizations, over 19,000 fewer deaths, and over $810 million in economic savings from a societal perspective compared with not vaccinating against RSV over a 5-year period. What has been learned from the study? (1-2 bullets): These analyses suggest the mRNA-1345 vaccine is a cost-saving strategy for the prevention of RSV in US adults across age groups and has the potential for substantial public health impact. Our findings may inform clinical and policy decision-making regarding the value of RSV vaccination in adults and support efforts to expand access among younger high-risk populations. PLAIN LANGUAGE SUMMARY: Respiratory syncytial virus (RSV) is a common virus that causes lung infections. It can be especially dangerous for older adults and people with health conditions like asthma, heart disease, or diabetes. Each year, RSV causes many hospital stays and even deaths in the United States. A new vaccine called mRNA-1345 was recently approved to protect adults aged 60 and older, and high-risk adults aged 18-59. This study looked at whether giving the vaccine to these groups would help prevent RSV infections and save money. Researchers used a mathematical model to compare what might happen over 5 years with and without the vaccine. They found that the vaccine could prevent over 280,000 hospital stays and more than 19,000 deaths. Even though the vaccine costs money, it would save more than $800 million by reducing medical bills and helping people stay healthy and working. RSV can place a heavy burden on individuals and the healthcare system. This study shows that the mRNA-1345 vaccine could protect the most vulnerable adults while also being a valuable investment for society.

Background/Objectives: Respiratory syncytial virus (RSV) is a leading cause of severe respiratory disease in older adults. Despite growing recognition of RSV as a public health concern, vaccination options remain limited. This study assessed the potential long-term public health impact of extended mRNA-1345 RSV vaccination campaigns. Methods: A dynamic transmission model, stratified by age, was developed to evaluate the epidemiological and clinical impact of RSV vaccination in the UK over a 20-year time horizon. Eight vaccination strategies were assessed: two reflecting the JCVI recommendation for the 2024–2025 season and its recent extension, and six extended strategies considering broader eligible age groups, higher coverage, and/or revaccination every 2 or 3 years. Two exploratory analyses and extensive model validation versus reported data were also conducted. Results: Strategies combining broader age eligibility (≥60 years), higher coverage (80%), and 2-year revaccination achieved the greatest impact, preventing 310,000 hospitalisations over 20 years in the total UK population. Exploratory analyses showed that the expected public health impact might exceed the estimates presented in this analysis, if an alternative vaccine efficacy profile or the projected demographic shift would be confirmed. Conclusions: Extended RSV vaccination strategies including broader age eligibility and routine revaccination could offer substantial public health benefits in the UK. Targeting adults aged ≥60 years is expected to be particularly efficient in achieving a sustainable reduction in RSV burden. These findings could provide valuable support for national policy discussions on optimising RSV vaccination strategies in older adults, particularly regarding target age groups, revaccination schedules, and long-term programme planning.

Background: Clinical trials showed mRNA-1345 (mRESVIA) was highly efficacious against RSV-associated lower respiratory tract disease in adults; real-world studies are critical to confirm vaccine impact on RSV-related healthcare usage.Methods: A retrospective matched test-negative case-control study used Veterans Health Administration electronic health records from the 2025–2026 respiratory season. Veterans aged ≥50 years with acute respiratory illness (ARI) who underwent RSV testing were included. Vaccine effectiveness (VE) of mRNA-1345 was estimated against RSV-positive ARI-associated hospitalization, urgent care/emergency department, and/or outpatient visits using multivariable conditional logistic regression. Results: The matched analysis included 2,500 RSV cases and 9,907 controls with balanced baseline characteristics. Among RSV-positive ARI-associated hospitalizations, <3 of 448 cases and 59 of 1,770 controls were vaccinated (VE of 87% (95%CI: 47%-97%)). Protection was consistent across settings.Conclusions: mRNA-1345 is associated with high protection against RSV-positive ARI-associated hospitalization that was generally consistent across medically-attended outcomes in the US Veteran population.