Cost-effectiveness of maternal vaccination against respiratory syncytial virus in Hong Kong: a decision-analytical analysis

Abstract

Background: Maternal vaccination against respiratory syncytial virus (RSV) showed high vaccine efficacy in preventing severe RSV-associated events in newborns in randomized controlled trials. This cost-effectiveness study evaluated year-round and seasonal maternal RSV vaccination in Hong Kong. Research design and methods: A decision-analytical model was constructed to evaluate the outcomes of three options: Year-round, seasonal, and no vaccination. Direct and indirect costs, RSV-associated lower respiratory infection, hospitalizations, pediatric intensive care unit admissions, deaths, QALYs loss, and incremental cost per QALY saved (ICER) were measured. Results: In base-case analysis, both year-round and seasonal vaccination reduced RSV-related events and saved QALYs at higher costs versus no vaccination. ICERs (versus no vaccination) of year-round (585,340 USD/QALY) and seasonal (560,460 USD/QALY) strategies exceeded willingness-to-pay (WTP) threshold 54,101 USD/QALY. Maternal vaccination strategies became cost-effective if RSV vaccine cost < USD67 for seasonal strategy and