Grant: Travel Awards - Institute Community Support

Respiratory syncytial virus (RSV) is one of the leading causes of hospitalization in infants in British Columbia. Each year, many babies (especially those born during the RSV season) become sick enough to need hospital care. New prevention options have recently become available in Canada, including a long-lasting antibody for infants (nirsevimab) and a vaccine given during pregnancy (RSVpreF) that protects newborns in their first months of life. Health systems now face the question: which approach offers the best protection for infants, and is it affordable to implement? In this study, we used real-world data from across BC to evaluate the health benefits, costs, and value for money of different RSV immunization strategies. We built a detailed simulation model that follows a newborn population through two RSV seasons, estimating how many infections, hospitalizations, ICU admissions, and deaths each strategy would prevent. We found that giving all infants nirsevimab at birth provides the greatest reduction in severe RSV disease, but it is also the most expensive option and not cost-effective at current prices. A combined program (offering maternal RSVpreF vaccination during pregnancy and giving nirsevimab only to infants at high or moderate medical risk) provides strong protection while representing good value for money for BC. This combination strategy could prevent a large portion of infant hospitalizations at a reasonable cost to the health-care system. Our findings support evidence-informed decision-making for RSV prevention in BC and can help guide the introduction of new immunization programs that improve infant health while using public health resources responsibly.