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Targeting respiratory syncytial virus (RSV) vaccinations at older people with underlying health conditions rather than the general population would reduce spending and prevent disease, according to a modelling study published yesterday. Canadian Medical Association Journal (CMJ).

The study compared the cost-effectiveness of different vaccine programs in different age groups with different medical risks.

Model It targets 100,000 people aged 50 years or older. Vaccine characteristics will be based on RSV vaccines approved in Canada as of May 2024, and vaccine protection is expected to last for 2 years.

The cost-effectiveness threshold was $50,000 per quality-adjusted life year (QALY).

Ideal for seniors with underlying conditions

The study authors estimated that without vaccination, 131,389 people (95% confidence interval) would die. [CrI]There are approximately 1,015 (95% CrI, 617-1,450) deaths annually among Canadians aged 60 years or older, with 12,068 (95% CrI, 10,324-13,883) medically treated RSV cases, 12,068 (95% CrI, 10,324-13,883) hospitalizations, and 1,015 (95% CrI, 617-1,450) deaths among Canadians aged 60 years or older.

A vaccination strategy based on age and risk of RSV infection-related complications was predicted to avert a median of 20% to 31% of outpatient cases, 38% to 42% of hospitalized cases, and 39% to 42% of deaths, the authors said. According to the model, the vaccine was most cost-effective when given to adults aged 70 and over with one or more chronic conditions.

We found that vaccinating older people may be less costly and more effective than not vaccinating them.

“We find that vaccinating seniors may be less costly and more effective than not vaccinating, and that vaccinating people aged 70 years and older with chronic conditions is likely to be cost-effective based on commonly used cost-effectiveness thresholds,” said Dr. Ashley Tuitt of the Public Health Agency of Canada. CMJ press release.

“A strategy focused on adults with underlying conditions that put them at increased risk of RSV infection is likely to be more cost-effective than a general age-based strategy,” Tuit added.

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