Potential impact of maternal vaccination on life-threatening respiratory syncytial virus infection during infancy

Vaccine. 2018 Jul 25;36(31):4693-4700. doi: 10.1016/j.vaccine.2018.06.021. Epub 2018 Jun 22.

Abstract

Background: Respiratory syncytial virus (RSV) infection is an important cause of infant mortality. Here, we estimated the potential impact of maternal vaccination against RSV on life-threatening RSV infection in infants.

Methods: We developed a mathematical model for maternal vaccine-induced antibody dynamics and used characteristics of a maternal RSV vaccine currently in phase 3 of clinical development. The model was applied to data from two cohorts of children younger than 12 months with RSV-related paediatric intensive care unit (PICU) admission in the United Kingdom (n = 370) and the Netherlands (n = 167), and a cohort of 211 children younger than 12 months with RSV-related in-hospital death from 20 countries worldwide.

Results: Our model predicted that, depending on vaccine efficiency, maternal vaccination at 30 weeks' gestational age could have prevented 62-75% of RSV-related PICU admissions in the United Kingdom and 76-87% in the Netherlands. For the global mortality cohort, the model predicted that maternal vaccination could have prevented 29-48% of RSV-related in-hospital deaths. Preterm children and children with comorbidities were predicted to benefit less than (healthy) term children.

Conclusions: Maternal vaccination against RSV may substantially decrease life-threatening RSV infections in infants.

Keywords: Infant mortality; Life-threatening infections; Maternal vaccination; Mathematical model; RSV.

MeSH terms

  • Antibodies, Viral / blood*
  • Antibody Formation*
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Models, Theoretical
  • Netherlands / epidemiology
  • Pregnancy
  • Respiratory Syncytial Virus Infections / epidemiology*
  • Respiratory Syncytial Virus Infections / mortality
  • Respiratory Syncytial Virus Infections / prevention & control*
  • Respiratory Syncytial Virus Vaccines / administration & dosage*
  • Respiratory Syncytial Virus Vaccines / immunology*
  • Survival Analysis
  • United Kingdom / epidemiology
  • Vaccination / methods*

Substances

  • Antibodies, Viral
  • Respiratory Syncytial Virus Vaccines