Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study
Background: Respiratory syncytial virus (RSV) is a leading cause of childhood mortality in infants below 6 months of age. In low-income and middle-income countries (LMICs), the public health burden is substantial and resources are limited. It is critical to inform decision makers about effectiveness...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-12-01
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| Series: | Vaccine: X |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590136223001201 |
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| author | Joukje E. Willemsen José A.M. Borghans Louis J. Bont Julia Drylewicz |
| author_facet | Joukje E. Willemsen José A.M. Borghans Louis J. Bont Julia Drylewicz |
| author_sort | Joukje E. Willemsen |
| collection | DOAJ |
| description | Background: Respiratory syncytial virus (RSV) is a leading cause of childhood mortality in infants below 6 months of age. In low-income and middle-income countries (LMICs), the public health burden is substantial and resources are limited. It is critical to inform decision makers about effectiveness of new interventions. Methods: We developed a mathematical model where individual RSV subtype A (RSV-A) and B (RSV-B) maternally derived neutralizing titers were predicted at time of birth after maternal vaccination with the RSV prefusion F protein-based vaccine. We estimated the subsequent duration of vaccine-induced immunity and compared this to the age at time of death distribution in the RSV GOLD Mortality Database to predict the potential impact of maternal vaccination on RSV-related childhood mortality. We used country-specific timing of antenatal care visits distributions and mortality estimates to make country-specific predictions for number of cases averted. Findings: The model predicts that on average a neonate born at 40 weeks gestational age will be protected between 6 and 7 months from RSV-A and approximately 5 months from RSV-B related mortality. We estimated the potential impact of RSV-related mortality for in-hospital and out-of-hospital cases in LMICs and predicted that in 51 GAVI-eligible countries maternal vaccination could avert between 55% and 63% of the RSV-related in-hospital mortality cases below 6 months of age. Interpretation: We show that maternal vaccination could substantially decrease RSV-A and RSV-B related in-hospital and out-of-hospital mortality in LMICs in the first 6 months of life. |
| first_indexed | 2024-03-08T22:43:58Z |
| format | Article |
| id | doaj.art-11c87e2ffe7745c4a5b5b23a098ed439 |
| institution | Directory Open Access Journal |
| issn | 2590-1362 |
| language | English |
| last_indexed | 2024-03-08T22:43:58Z |
| publishDate | 2023-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Vaccine: X |
| spelling | doaj.art-11c87e2ffe7745c4a5b5b23a098ed4392023-12-17T06:41:31ZengElsevierVaccine: X2590-13622023-12-0115100379Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling studyJoukje E. Willemsen0José A.M. Borghans1Louis J. Bont2Julia Drylewicz3Centre for Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands; Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, The NetherlandsCentre for Translational Immunology, University Medical Centre Utrecht, Utrecht, The NetherlandsDivision of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, The NetherlandsCentre for Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands; Corresponding author.Background: Respiratory syncytial virus (RSV) is a leading cause of childhood mortality in infants below 6 months of age. In low-income and middle-income countries (LMICs), the public health burden is substantial and resources are limited. It is critical to inform decision makers about effectiveness of new interventions. Methods: We developed a mathematical model where individual RSV subtype A (RSV-A) and B (RSV-B) maternally derived neutralizing titers were predicted at time of birth after maternal vaccination with the RSV prefusion F protein-based vaccine. We estimated the subsequent duration of vaccine-induced immunity and compared this to the age at time of death distribution in the RSV GOLD Mortality Database to predict the potential impact of maternal vaccination on RSV-related childhood mortality. We used country-specific timing of antenatal care visits distributions and mortality estimates to make country-specific predictions for number of cases averted. Findings: The model predicts that on average a neonate born at 40 weeks gestational age will be protected between 6 and 7 months from RSV-A and approximately 5 months from RSV-B related mortality. We estimated the potential impact of RSV-related mortality for in-hospital and out-of-hospital cases in LMICs and predicted that in 51 GAVI-eligible countries maternal vaccination could avert between 55% and 63% of the RSV-related in-hospital mortality cases below 6 months of age. Interpretation: We show that maternal vaccination could substantially decrease RSV-A and RSV-B related in-hospital and out-of-hospital mortality in LMICs in the first 6 months of life.http://www.sciencedirect.com/science/article/pii/S2590136223001201Maternal vaccinationRSVVaccine efficacyMathematical modelPredictive modellingInfant mortality |
| spellingShingle | Joukje E. Willemsen José A.M. Borghans Louis J. Bont Julia Drylewicz Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study Vaccine: X Maternal vaccination RSV Vaccine efficacy Mathematical model Predictive modelling Infant mortality |
| title | Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study |
| title_full | Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study |
| title_fullStr | Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study |
| title_full_unstemmed | Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study |
| title_short | Maternal vaccination against RSV can substantially reduce childhood mortality in low-income and middle-income countries: A mathematical modeling study |
| title_sort | maternal vaccination against rsv can substantially reduce childhood mortality in low income and middle income countries a mathematical modeling study |
| topic | Maternal vaccination RSV Vaccine efficacy Mathematical model Predictive modelling Infant mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2590136223001201 |
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