Abstract
Background
Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract infections (LRTIs) in infants, imposing a substantial burden in Greece. Current prevention targets high-risk groups and selected birth cohorts, while recent advances, including long-acting monoclonal antibodies and maternal vaccines, enable broader protection and have been adopted in National Immunization Programs worldwide. Evaluating the impact of expanding RSV immunization in Greece is essential to inform policy decisions.
Methods
A population-based budget impact model compared three strategies: (1) current targeted approach, (2) extended coverage including infants born up to three months before the RSV season, and (3) universal immunization. The analysis incorporated long-acting monoclonal antibodies and maternal vaccination. Epidemiological and cost inputs were applied to estimate healthcare utilization and costs, with age- and risk-specific rates. Economic impact was assessed by comparing intervention costs against savings from avoided hospitalizations and medically attended infections. Coverage was set at 80%.
Results
The current strategy was estimated to prevent 6,400 LRTIs, including 2,262 hospitalizations, corresponding to €26.6 million in savings. Extending coverage increased impact to 7,932 LRTIs and 2,716 hospitalizations avoided, with €28.3 million in savings. Universal immunization showed the greatest benefit, preventing 10,753 LRTIs and 3,023 hospitalizations, generating €30.2 million in savings. Including immunization costs, the universal strategy remained cost-saving, with net annual savings exceeding €5.2 million.
Conclusions
Expanding RSV immunization in Greece is expected to reduce disease burden and healthcare utilization while generating net savings. The increasing benefits across strategies support broader approaches and inform national policy decisions.
Key messages
• Expanding RSV immunization coverage in Greece substantially reduces disease burden, preventing thousands of LRTIs and hospitalizations, with the greatest impact observed under universal immunization.
• Universal RSV immunization is cost-saving, generating net annual savings (>€5 million) by offsetting intervention costs through reduced healthcare utilization.