Respiratory syncytial virus (RSV) vaccine effectiveness against RSV-associated hospitalisations and emergency department encounters among adults aged 60 years and older in the USA, October, 2023, to March, 2024: a test-negative design analysis.
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Payne Amanda B, Watts Janet A, Mitchell Patrick K, Dascomb Kristin, Irving Stephanie A, Klein Nicola P, Grannis Shaun J, Ong Toan C, Ball Sarah W, DeSilva Malini B, Natarajan Karthik, Sheffield Tamara, Bride Daniel, Arndorfer Julie, Naleway Allison L, Koppolu Padma, Fireman Bruce, Zerbo Ousseny, Timbol Julius, Goddard Kristin, Dixon Brian E, Fadel William F, Rogerson Colin, Allen Katie S, Rao Suchitra, Mayer David, Barron Michelle, Reese Sarah E, Rowley Elizabeth A K, Najdowski Morgan, Ciesla Allison Avrich, Mak Josephine, Reeves Emily L, Akinsete Omobosola O, McEvoy Charlene E, Essien Inih J, Tenforde Mark W, Fleming-Dutra Katherine E, Link-Gelles Ruth
Аннотация
METHODS: We conducted a test-negative design analysis in an electronic health records-based network in eight states in the USA, including hospitalisations and emergency department encounters with respiratory syncytial virus-like illness among adults aged at least 60 years who underwent respiratory syncytial virus testing from Oct 1, 2023, to March 31, 2024. Respiratory syncytial virus vaccination status at the time of the encounter was derived from electronic health record documentation, state and city immunisation registries, and, for some sites, medical claims. Vaccine effectiveness was estimated by immunocompromise status, comparing the odds of vaccination among respiratory syncytial virus-positive case patients and respiratory syncytial virus-negative control patients, and adjusting for age, race and ethnicity, sex, calendar day, social vulnerability index, number of underlying non-respiratory medical conditions, presence of respiratory underlying medical conditions, and geographical region.
FINDINGS: Among 28 271 hospitalisations for respiratory syncytial virus-like illness among adults aged at least 60 years without immunocompromising conditions, vaccine effectiveness was 80% (95% CI 71-85) against respiratory syncytial virus-associated hospitalisations, and vaccine effectiveness was 81% (52-92) against respiratory syncytial virus-associated critical illness (ICU admission or death, or both). Among 8435 hospitalisations for respiratory syncytial virus-like illness among adults with immunocompromising conditions, vaccine effectiveness was 73% (48-85) against associated hospitalisation. Among 36 521 emergency department encounters for respiratory syncytial virus-like illness among adults aged at least 60 years without an immunocompromising condition, vaccine effectiveness was 77% (70-83) against respiratory syncytial virus-associated emergency department encounters. Vaccine effectiveness estimates were similar by age group and product type.
INTERPRETATION: Respiratory syncytial virus vaccination was effective in preventing respiratory syncytial virus-associated hospitalisations and emergency department encounters among adults aged at least 60 years in the USA during the 2023-24 respiratory syncytial virus season, which was the first season after respiratory syncytial virus vaccine was approved.
FUNDING: The Centers for Disease Control and Prevention.