Nienke M Scheltema1, Xynthia M Kavelaars2, Kentigern Thorburn3, Marije P Hennus4, Job B van Woensel5, Cornelis K van der Ent6, José A M Borghans7, Louis J Bont8, Julia Drylewicz9. 1. Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. 2. Department of Methods and Statistics, Tilburg University, Tilburg, The Netherlands. 3. Department of Paediatric Intensive Care, Alder Hey Children's Hospital, Liverpool, United Kingdom. 4. Department of Paediatric Intensive Care, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. 5. Department of Paediatric Intensive Care, Emma Children's Hospital, Academic Medical Centre, Amsterdam, The Netherlands. 6. Department of Paediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands. 7. Laboratory of Translational Immunology, Department of Immunology, University Medical Centre Utrecht, Utrecht, the Netherlands. 8. Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands; Laboratory of Translational Immunology, Department of Immunology, University Medical Centre Utrecht, Utrecht, the Netherlands. 9. Laboratory of Translational Immunology, Department of Immunology, University Medical Centre Utrecht, Utrecht, the Netherlands. Electronic address: J.Drylewicz@umcutrecht.nl.
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.
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.
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