Evaluation report
Evaluating the impact of RSV immunisation strategies on antibiotic use in England
Katherine E. Atkins, David B. Hodgson, Mark Jit, Nicholas G. Davies ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study evaluated how RSV immunisation strategies could reduce antibiotic prescribing in primary care in England. The researchers combined transmission modelling of RSV with statistical analysis to estimate the impact of different vaccination approaches. Vaccinating children aged 5-14 years could reduce antibiotic prescribing substantially, while administering monoclonal antibodies to high-risk infants under 6 months was found to be the most efficient strategy. These reductions in antibiotic use would prevent some cases of drug-resistant infections.
Key points
- Targeting children aged 5-14 years with RSV vaccination reduces antibiotic prescribing by 10.9 courses per 10,000 person-years
- Seasonal monoclonal antibodies for high-risk infants under 6 months is the most efficient strategy, reducing prescribing by 2.6 courses per 1,000 mAb courses
- Reduced antibiotic use from RSV immunisation would gain 128 DALYs and avert 51,000 GBP in costs from drug-resistant bacterial infections
- A substantial fraction of primary care antibiotics are prescribed for RSV-related illness
Limitations
This is a modelling study based on assumptions and statistical attribution rather than real-world trial data, so actual impacts of implementing these strategies may differ. The study does not evaluate implementation barriers, acceptability, or equity considerations in vaccine rollout.
Abstract
Abstract With a sizable fraction of primary care antibiotics prescribing attributable to RSV, the promising suite of prophylactic pharmaceuticals against could reduce the need for antibiotics in addition to controlling respiratory disease. To assess the potential impact of RSV vaccines on the reduction in primary care antibiotic prescribing in England, we integrate results from a dynamic transmission model of RSV and a statistical attribution framework. Under base case assumptions, targeting children aged 5-14 years reduces antibiotic prescribing by 10.9 (8.0-14.2) antibiotic courses per 10,000 person years. This reduction in antibiotic use would gain 128 DALYs and avert 51,000 GBP associated with infections caused by drug resistant bacteria. Seasonally administering monoclonal antibodies (mAbs) to high risk infants under 6 months is the most efficient strategy (reducing per person year antibiotic prescribing by 2.6 (1.9-3.3) antibiotic courses per 1,000 mAb courses).