Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study

Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study

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Background: Respiratory syncytial virus (RSV) is a leading cause of childhood mortality in infants below 6 months of age.In low-income and middle-income countries (LMICs), the public health burden is substantial and resources are limited.It is critical to inform decision makers about effectiveness of new interventions.Methods: We developed a mathematical model where here individual RSV subtype A (RSV-A) and B (RSV-B) maternally derived neutralizing titers were predicted at time of birth after maternal vaccination with the RSV prefusion F protein-based vaccine.We estimated the subsequent duration of vaccine-induced immunity and compared this to the age at time of death distribution in the RSV GOLD Mortality Database to predict the potential impact of maternal vaccination on RSV-related childhood mortality.

We used country-specific timing of antenatal care visits distributions and mortality estimates to make country-specific predictions for number of cases averted.Findings: The model predicts that on average a neonate born at 40 weeks gestational age will be protected between 6 and 7 months from RSV-A and approximately 5 months from RSV-B related mortality.We estimated the potential impact of RSV-related mortality for in-hospital and out-of-hospital cases in LMICs and predicted that in 51 GAVI-eligible countries maternal vaccination laguna 3hp dust collector could avert between 55% and 63% of the RSV-related in-hospital mortality cases below 6 months of age.Interpretation: We show that maternal vaccination could substantially decrease RSV-A and RSV-B related in-hospital and out-of-hospital mortality in LMICs in the first 6 months of life.