Figure 4.

Forest plot evaluating whether infants who did not receive RSV immunoprophylaxis had increased odds of subsequent wheezing illness

If RSV-LRTI were a cause of subsequent wheezing illness, then we would expect infants (aged 0-1 years) not receiving RSV immunoprophylaxis to have greater odds of developing subsequent wheezing illness compared with infants at similar risk who do receive RSV immunoprophylaxis. Our analyses from RSV immunoprophylaxis studies provided insufficient evidence for this hypothesis. In the figure, log_eOR >0 indicate greater odds of subsequent wheezing illness in children who did not receive immunoprophylaxis. The higher of the two diamonds depicts the weighted mean log_eOR for randomised trials and observational studies that adjusted for confounders. The lower of the two diamonds depicts the weighted mean log_eOR across all estimates, including those from observational studies that did not adjust for confounders. Neither mean estimate was significantly greater than 0. RSV-LRTI=respiratory syncytial virus lower respiratory tract infection. Log_eOR= log_e odds ratios. *Estimates from the Blanken et al³³ and Scheltema et al³⁴ were based on outcomes measured after the blinding of study participants had been broken at 1 year of age, although assessors were blinded throughout the study.