Respiratory syncytial virus (RSV) remains a primary driver of pediatric morbidity and mortality in low- and middle-income countries (LMICs). Consequently, healthcare educators and policymakers are closely evaluating RSV prevention cost-effectiveness to guide the introduction of new immunizations. A recent modeling study based in Cameroon provides critical insights for Gavi-eligible nations. Specifically, it analyzed the potential of two emerging interventions: the long-acting monoclonal antibody nirsevimab and the bivalent maternal vaccine RSVpreF.

The researchers utilized a static proportionate outcomes model to project the health benefits of these interventions between 2025 and 2034. Their findings suggest that both strategies can significantly reduce the pediatric disease burden. For instance, with coverage rates of 65% to 69%, these interventions could avert approximately 27% of RSV-related deaths among children under five years old. Furthermore, both strategies show a notable impact on reducing clinic visits and hospital admissions, which frequently strain local health systems.

Achieving RSV Prevention Cost-Effectiveness

Economic viability in LMICs is heavily dependent on the price per dose. According to the study, both nirsevimab and the maternal vaccine achieve RSV prevention cost-effectiveness at a price of USD 5 per dose when applying a threshold of 0.5 GDP per capita. However, in more budget-constrained settings, the required price point is lower. For the interventions to be considered cost-effective at a 0.1 GDP per capita threshold, the price must drop below USD 2.50 per dose. Consequently, international support through organizations like Gavi is essential for making these tools affordable.

Moreover, the duration of protection plays a vital role in clinical outcomes. The model assumed five months of efficacy for the infant monoclonal antibody and six months for the maternal vaccine. Because RSV is often seasonal, the timing of administration is a critical factor for maximizing impact. These findings are highly relevant for clinicians in countries like India, where the burden of RSV-associated lower respiratory tract infections remains substantial and national immunization policies are under constant review.

Frequently Asked Questions

What is the estimated impact of these interventions on pediatric mortality?

Modeling suggests that nirsevimab and the maternal vaccine could avert between 2226 and 2267 RSV-related deaths over a decade in a country like Cameroon, representing a reduction of roughly 27%.

At what price point is RSV immunization most cost-effective?

To meet strict cost-effectiveness thresholds in low-resource settings (0.1 GDP per capita), interventions should ideally be priced below USD 2.50 per dose. At USD 5 per dose, they remain cost-effective at more flexible thresholds.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional recommendation. Clinical decisions should be made by qualified healthcare providers based on individual patient needs. Refer to the latest local and national guidelines for clinical practice.

References

1. Shaaban FL et al. Impact and cost-effectiveness of two interventions to prevent paediatric respiratory syncytial virus disease in Cameroon: a modelling approach. J Glob Health. 2026 Apr 30. doi: 10.7189/jogh.16.04051. PMID: 42060341.


2. World Health Organization. Report of the WHO technical consultation on the evaluation of respiratory syncytial virus prevention cost-effectiveness in low- and middle-income countries. 2022.


3. Li Y et al. Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis. Lancet. 2022;399(10340):2047-2064.