RSV prevention for all infants

Summary

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Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infections in children worldwide. Since the highest burden occurs under six months of age, maternal vaccination or infant immunisation is the key preventive strategy.

Considerations to implement new preventive strategies to immunisation programmes are guided by information, including data on disease burden, vaccine safety and efficacy, cost-effectiveness and acceptance of the strategy in the population. In light of the Dutch Health council’s advice, this thesis aimed to provide data to support introduction of RSV immunisation to protect all Dutch infants. In addition, this thesis reflects on the Health councils advice in view of newly emerged evidence.

Ultimately, the acceptance and uptake of vaccines is needed for effective implementation in the NIP. Our research found that most women expressed a positive attitude to obtain either RSV preventive option, but preferred maternal vaccination. A parallel roll out of both options could potentially be most cost-effective. And most importantly, given the comparable safety and efficacy, combined with the decline in vaccine coverage, allowing an individual choice using the shared decision-making approach with the healthcare professional, may help to ensure RSV immunisation uptake. In an ideal setting, vaccine information is provided by a trained healthcare professional who is also competent to administer the vaccine immediately afterwards. Continuous evaluation of the shared decision-making approach should assess its impact on the NIP uptake.