Estimation of Public Health Impact with Use of Nirsevimab During the 2024-2025 RSV Season in the USA: a Modeling Study.

IF 3.4 Q2 RESPIRATORY SYSTEM

Pulmonary Therapy Pub Date : 2026-06-01 Epub Date: 2026-02-26 DOI:10.1007/s41030-026-00348-z

Benjamin Yarnoff, Maureen P Neary, Veronica Gabriel, Mehdi Ghemmouri, Erin N Hodges, Maribel Tribaldos, Jeroen Geurtsen, Ayman Chit, Matthieu Beuvelet, Samira Soudani, Robert Musci, Leonard R Krilov

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引用次数: 0

Abstract

Introduction: Respiratory syncytial virus (RSV) is a leading cause of medically attended lower respiratory tract disease (MA-LRTD) and hospitalization among infants in the USA. With the introduction in 2023 of nirsevimab, a long-acting monoclonal antibody for infant RSV prevention, early data on observed uptake provides an opportunity to quantify its public health impact. We hypothesized that the observed nirsevimab immunization coverage rate during the 2024-2025 RSV season substantially reduced the clinical burden of RSV relative to the pre-2023 standard of practice (SoP) and that increasing coverage levels comparable with other routine pediatric immunizations would yield substantial reductions in RSV-associated outcomes.

Methods: We employed a previously published and validated static decision model to estimate RSV MA-LRTDs under multiple nirsevimab coverage scenarios. The analysis compared projected RSV burden under the pre-2023 SoP where only high-risk infants receive palivizumab with scenarios reflecting the observed national nirsevimab coverage during the 2024-2025 RSV season (44.7%) and higher hypothetical coverage levels up to universal, 100% coverage among infants not eligible for palivizumab. Outcomes included RSV-related hospitalizations, emergency room (ER) visits, primary care (PC) visits, and RSV-associated deaths. Number needed to immunize (NNI) values were also calculated relative to the pre-2023 SoP.

Results: Under the pre-2023 SoP, the model estimated 523,594 RSV MA-LRTDs among infants during the 2024-2025 RSV season. At the observed nirsevimab coverage of 44.7%, 204,306 RSV MA-LRTDs were averted, including 18,765 hospitalizations (42% reduction), 49,570 ER visits (39%), and 135,942 PC visits (39%). Increasing coverage to 80.4%-aligned with uptake for other routine infant vaccines-was projected to avert 364,204 RSV MA-LRTDs (159,898 additional cases prevented beyond the 44.7% scenario), including 32,404 hospitalizations (73% reduction). Universal coverage (100%) yielded the greatest benefit, averting 451,991 cases (86% reduction) and 39,891 hospitalizations. The number needed to immunize (NNI) was 9 for one MA-LRTD averted, 91 for one hospitalization, and 34 for one ER visit.

Conclusions: Nirsevimab has already achieved substantial reductions in RSV-associated clinical burden at current national coverage levels. Modeled increases in coverage demonstrate large, incremental public health gains with complete universal immunization yielding up to an 86% reduction in RSV MA-LRTDs. These findings highlight the importance of implementing strategies that enhance access, reduce inequities, and support higher, sustained coverage to maximize population-level benefits of RSV prophylaxis.

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美国2024-2025年RSV流行季节使用Nirsevimab对公众健康影响的评估：一项模型研究

在美国，呼吸道合胞病毒（RSV）是导致婴儿下呼吸道疾病（MA-LRTD）和住院的主要原因。随着2023年引入nirsevimab（一种用于婴儿RSV预防的长效单克隆抗体），早期观察到的摄取数据为量化其公共卫生影响提供了机会。我们假设，与2023年之前的实践标准（SoP）相比，在2024-2025 RSV季节观察到的nirseimab免疫覆盖率大大降低了RSV的临床负担，并且与其他常规儿科免疫相比，增加覆盖率水平将大大降低RSV相关的结果。方法：我们采用先前发表并经过验证的静态决策模型来估计多种nirsevimab覆盖情景下的RSV ma - lrtd。该分析比较了2023年之前SoP下的RSV预期负担，即只有高风险婴儿接受帕利珠单抗，与反映2024-2025年RSV季节观察到的全国尼希米单抗覆盖率（44.7%）的情景和更高的假设覆盖率水平，即在不符合帕利珠单抗条件的婴儿中达到普遍的100%覆盖率。结果包括与rsv相关的住院、急诊室（ER）就诊、初级保健（PC）就诊和与rsv相关的死亡。相对于2023年之前的SoP，还计算了需要免疫的数量（NNI）值。结果：在2023年之前的SoP下，该模型估计2024-2025年RSV季节婴儿中有523,594例RSV ma - lrtd。在观察到的nirseimab覆盖率为44.7%时，避免了204,306例RSV ma - lrtd，包括18,765例住院（减少42%），49,570例急诊（39%）和135,942例PC就诊（39%）。将接种率提高到80.4%——与其他常规婴儿疫苗接种率保持一致——预计可避免364,204例RSV MA-LRTDs（在44.7%的情况下可预防159,898例额外病例），包括32,404例住院（减少73%）。全民覆盖（100%）产生了最大的效益，避免了451,991例病例（减少86%）和39,891例住院。预防一次MA-LRTD需要接种疫苗（NNI） 9次，一次住院需要接种91次，一次急诊需要接种34次。结论：在目前的国家覆盖水平上，Nirsevimab已经大幅降低了rsv相关的临床负担。模拟的覆盖率增加表明，完全普及免疫可使RSV ma - lrtd减少86%，从而获得巨大的渐进式公共卫生收益。这些发现强调了实施战略的重要性，这些战略可促进可及性，减少不公平现象，并支持更高、持续的覆盖率，以最大限度地提高RSV预防在人群层面的效益。

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来源期刊

Pulmonary Therapy Medicine-Pulmonary and Respiratory Medicine

CiteScore

5.20

自引率

3.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Pulmonary Therapy is an international, open access, peer-reviewed (single-blind), and rapid publication journal. The scope of the journal is broad and will consider all scientifically sound research from pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the use of pulmonary therapies, devices, and surgical techniques. Areas of focus include, but are not limited to: asthma; chronic obstructive pulmonary disease; idiopathic pulmonary fibrosis; pulmonary hypertension; cystic fibrosis; lung cancer; respiratory tract disorders; allergic rhinitis and other respiratory allergies; influenza, pneumococcal infection, respiratory syncytial virus and other respiratory infections; and inhalers and other device therapies. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/series, trial protocols and short communications such as commentaries and editorials. Pulmonary Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. Rapid Publication The journal’s publication timelines aim for a rapid peer review of 2 weeks. If an article is accepted it will be published 3–4 weeks from acceptance. The rapid timelines are achieved through the combination of a dedicated in-house editorial team, who manage article workflow, and an extensive Editorial and Advisory Board who assist with peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid, efficient communication of the latest research and reviews, fostering the advancement of pulmonary therapies. Open Access All articles published by Pulmonary Therapy are open access. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning authors will always have an editorial contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. Digital Features and Plain Language Summaries Pulmonary Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit our showcase page https://springerhealthcare.com/expertise/publishing-digital-features/ Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of €4500/ $5100/ £3650. The journal will consider fee discounts and waivers for developing countries and this is decided on a case by case basis. Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials, and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case-by-case basis and should be sent to the journal editor. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors’ or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. 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For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0. Contact For more information about the journal, including pre-submission enquiries, please contact christopher.vautrinot@springer.com.