The potential public health impact of new immunization strategies for the prevention of RSV in children in Panama.

Objective: New prophylaxis to reduce the burden of respiratory syncytial virus (RSV) disease are available, including a long-acting monoclonal antibody (nirsevimab) and maternal immunization with an RSV prefusion F protein vaccine (RSVpreF). We compared the potential public health impact of these strategies when implemented in Panama from the payer perspective.

Methods: A static model evaluated the use of year-round nirsevimab with/without catch-up, seasonal nirsevimab with catch-up, and RSVpreF in a birth cohort. Health, cost, quality-of-life outcomes, and the number needed to immunize (NNI) were compared to the current standard of care, followed by an indirect comparison of nirsevimab and RSVpreF.

Results: Seasonal nirsevimab with catch-up would be the most effective strategy as it would prevent 62% RSV-associated lower respiratory tract disease cases compared to RSVpreF, followed by year-round nirsevimab with catch-up that would prevent 46% of cases. Each of the nirsevimab strategies would have a greater impact on all outcomes compared to RSVpreF. The NNI to prevent an RSV infection and death was lower for the nirsevimab strategies compared to RSVpreF.

Conclusion: RSV immunization strategies would significantly reduce the disease burden in Panama. Nirsevimab would have a greater public health impact than RSVpreF due to its sustained efficacy and protection regardless of gestational age.