International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Effectiveness of nirsevimab and maternal RSVpreF vaccination against infant hospitalization across the island of Ireland.
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Treston Bryony, O'Hagan Shaun, Barrett Michael, Marlow Robin, Williams Thomas, Lyttle Mark, Roland Damian, Walsh Aisling, Waterfield Thomas, Geoghegan Sarah, Groves Helen
Аннотация
OBJECTIVES: In 2024, two respiratory syncytial virus (RSV) immunization strategies were introduced on the island of Ireland: nirsevimab in Republic of Ireland (ROI) and RSVpreF in Northern Ireland (NI). The primary objective was to estimate effectiveness against hospitalized RSV-associated acute lower respiratory infection (ALRI) in infants <6 months. The secondary objective was to compare impact on emergency department (ED) bronchiolitis attendances.
METHODS: We conducted a multicentre, test-negative, case-control study across five sites during the 2024/25 season. Effectiveness against hospitalization was estimated using multivariable logistic regression adjusting for age <3 months, sex, and prematurity. Infants born after 1 September 2024, hospitalized with ALRI, and tested for RSV were eligible. Time series modeling compared ED bronchiolitis attendances during the study season with five preceding seasons.
RESULTS: 254 infants were included (ROI:165, NI: 89). In ROI, 34% of cases and 83% of controls received nirsevimab; in NI, 6% and 30% received RSVpreF respectively. Adjusted effectiveness against hospitalization was 90.7% (95% CI: 80.7-95.8) for nirsevimab and 83.9% (95% CI: 41.5-96.6) for RSVpreF. Modeling showed significant reductions in ED bronchiolitis attendances; greater in ROI (52%) than NI (37%).
CONCLUSIONS: Both interventions were highly effective against RSV-ALRI hospitalization. However, coverage differed markedly, with important implications for population-level impact.
METHODS: We conducted a multicentre, test-negative, case-control study across five sites during the 2024/25 season. Effectiveness against hospitalization was estimated using multivariable logistic regression adjusting for age <3 months, sex, and prematurity. Infants born after 1 September 2024, hospitalized with ALRI, and tested for RSV were eligible. Time series modeling compared ED bronchiolitis attendances during the study season with five preceding seasons.
RESULTS: 254 infants were included (ROI:165, NI: 89). In ROI, 34% of cases and 83% of controls received nirsevimab; in NI, 6% and 30% received RSVpreF respectively. Adjusted effectiveness against hospitalization was 90.7% (95% CI: 80.7-95.8) for nirsevimab and 83.9% (95% CI: 41.5-96.6) for RSVpreF. Modeling showed significant reductions in ED bronchiolitis attendances; greater in ROI (52%) than NI (37%).
CONCLUSIONS: Both interventions were highly effective against RSV-ALRI hospitalization. However, coverage differed markedly, with important implications for population-level impact.