• Zhanwei Du, Lin Wang, Yuan Bai, Yao Pei, Peng Wu, and Benjamin J Cowling.
• WHO Collaborating Center for Infectious Disease Epidemiology and Control, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China; Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, Hong Kong Special Administrative Region, China.
• Lancet. 2023 Nov 1; 402 Suppl 1: S39S39.

BackgroundThe RSVpreF vaccines have breakthrough progress. The respiratory syncytial virus (RSV) vaccine for older adults from GlaxoSmithKline was the first RSV vaccine approved by the US Food and Drug Administration (FDA) in early May 2023, followed by the subsequent FDA approval of Pfizer's RSV vaccines for older adults and pregnant women. We aimed to estimate the public health impact of the potential population-level administrations of the RSVpreF vaccine in the UK.MethodsIn this modelling study, we used national census and contact survey data to construct an individual-based mathematical model, with interpersonal connections characterising household structure, social settings, and age-specific contact patterns. We considered both within-host viral-load dynamics and between-host RSV transmission. We modelled the coverages of RSV vaccines for older people (age ≥60 years) and pregnant women, using influenza vaccination data from the 2018-19 season. We explored a range of possible transmissibility and estimated the health burden averted by RSVpreF vaccine over a 300-day period as compared with the control scenario without vaccines.FindingsIn a low-transmission scenario (Re=1·2), RSVpreF would avert a total population of 2·35 (95% credible interval [CrI] 1·24-3·77) million infections, 12.80 (95% CrI 8·60-17·06) thousand hospital admissions, and 0·93 (95% CrI 0·69-1·25) thousand deaths, with 1·82 (1·41-2·33) million infections, 12·44 (8·50-16·38) thousand hospital admissions, and 0·93 (0·67-1·23) thousand deaths averted for people aged 60 years and older. In a high-transmission scenario (Re=2·0), RSVpreF would avert 2·01 (1·37-2·68) million infections, 14·67 (10·05-18·33) thousand hospital admissions, and 1·12 (0·80-1·35) thousand deaths. The majority averted would still be among older adults.InterpretationOur mathematical models will help improve the vaccine schedules of RSVpreF. Future work will address several limitations when data become available, including the incorporation of population immunity, potential vaccine hesitancy, and other factors affecting vaccine uptake and effectiveness.FundingGovernment of the Hong Kong Special Administrative Region, the European Research Council, and Ministry of Science and Technology of the People's Republic of China.Copyright © 2023 Elsevier Ltd. All rights reserved.

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