Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 11:58:127191.
doi: 10.1016/j.vaccine.2025.127191. Epub 2025 May 17.

Cost-effectiveness of bivalent respiratory syncytial virus Prefusion F (RSVpreF) maternal vaccine among infants in the United States

Ahuva Averin  1 , Erin Quinn  2 , Mark Atwood  2 , Derek Weycker  2 , Kimberly M Shea  3 , Amy W Law  3
Affiliations
Free article

Cost-effectiveness of bivalent respiratory syncytial virus Prefusion F (RSVpreF) maternal vaccine among infants in the United States

Ahuva Averin et al. Vaccine. .
Free article

Abstract

Background: Respiratory syncytial virus (RSV) is a leading cause of respiratory tract illness (RTI) among young children. The novel bivalent stabilized prefusion F subunit vaccine (RSVpreF) for pregnant people to protect their infants against RSV lower respiratory tract illness (RSV-LRTI) was recommended by the US Advisory Committee on Immunization Practices for use among pregnant persons between 32 and 36 weeks of gestation in September 2023. We evaluated the cost-effectiveness of maternal RSVpreF for prevention of RSV among US infants.

Methods: A cohort model was employed to depict clinical outcomes and economic costs of RSV from birth to age 1 year and lifetime consequences of premature RSV-related death. Cost-effectiveness of year-round and, alternatively, seasonally administered RSVpreF was evaluated compared to no intervention. Model inputs include RSV disease and case-fatality rates; vaccine effectiveness (derived from trial analyses); and costs of RSVpreF, RSV treatment, and caregiver work loss. Clinical outcomes (projected monthly) included cases of medically attended RSV, RSV-LRTI deaths, and quality-adjusted LYs (QALYs). Economic costs were generated based on vaccines administered as well as cases and corresponding unit costs and were reported in 2023 US$. Costs and benefits were discounted 3 % annually.

Results: Year-round maternal vaccination with RSVpreF resulted in a reduction of 13,349 hospitalizations, 32,414 emergency department encounters, and 96,540 outpatient clinic visits, corresponding with an increase in direct medical costs of $366 million and decrease in indirect (non-medical) costs of $80 million. With 2264 additional QALYs, the cost-effectiveness ratio was $89,733/QALY. Seasonal maternal vaccination prevented 23-39 % fewer cases (care setting dependent), but was cost saving overall, resulting in a dominant cost-effectiveness ratio.

Conclusion: Maternal vaccination with RSVpreF would substantially reduce the clinical and economic burden of RSV in infants, resulting in a cost-effectiveness ratio of $89,733 per QALY if administered year-round or cost savings if administered seasonally.

Keywords: Cost-effectiveness; Infants; Maternal vaccination; Respiratory syncytial virus.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Ahuva Averin, Erin Quinn, and Mark Atwood are employees of Avalere Health, which received funding from Pfizer in connection with the development of this manuscript and study. Kimberly Shea and Amy Law are employed by, and are shareholders of, Pfizer Inc.

MeSH terms

Substances

LinkOut - more resources