Martin Wetzke, Duyen Bao Le, Inga Tometten, Simon Ritter, Nadine Lübke, Jörg Timm, Alexander Dilthey, Marcus Panning, Andreas Walker, Christine Happle
Background
The emergence of resistance-associated substitutions in RSV against novel monoclonal antibodies is a concern given widespread prophylactic use.
Aim
To assess the prevalence of resistance-associated substitutions in the RSV F protein against nirsevimab, clesrovimab, and palivizumab in German infants before widespread implementation of nirsevimab.
Materials & Methods
We sequenced the F protein of n = 1042 RSV samples from German infants from seasons 2021/2022 and 2022/2023 and screened for variants in binding sites for nirsevimab (Site Ø), clesrovimab (Site IV), and palivizumab (Site II).
Results
Prevalence of resistance-associated substitutions was low (< 1%) for all three monoclonal antibodies.
Conclusion
Although the current risk of infections with escape-mutants appears to be low, our results underline the need for continued surveillance, as resistance-conferring mutations to new mAbs circulated and may be selected under selection pressure.
{"title":"Prevalence of Resistance-Associated Mutations in RSV F Protein Against Monoclonal Antibodies Prior to Widespread Implementation: Findings From a Prospective German Pediatric Cohort","authors":"Martin Wetzke, Duyen Bao Le, Inga Tometten, Simon Ritter, Nadine Lübke, Jörg Timm, Alexander Dilthey, Marcus Panning, Andreas Walker, Christine Happle","doi":"10.1111/irv.70164","DOIUrl":"10.1111/irv.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The emergence of resistance-associated substitutions in RSV against novel monoclonal antibodies is a concern given widespread prophylactic use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the prevalence of resistance-associated substitutions in the RSV F protein against nirsevimab, clesrovimab, and palivizumab in German infants before widespread implementation of nirsevimab.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials & Methods</h3>\u0000 \u0000 <p>We sequenced the F protein of <i>n</i> = 1042 RSV samples from German infants from seasons 2021/2022 and 2022/2023 and screened for variants in binding sites for nirsevimab (Site Ø), clesrovimab (Site IV), and palivizumab (Site II).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prevalence of resistance-associated substitutions was low (< 1%) for all three monoclonal antibodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the current risk of infections with escape-mutants appears to be low, our results underline the need for continued surveillance, as resistance-conferring mutations to new mAbs circulated and may be selected under selection pressure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iván Martínez-Baz, Camino Trobajo-Sanmartín, Miguel Fernández-Huerta, Ana Navascués, Aitziber Echeverria, Nerea Egüés, Noelia Vera-Punzano, María Eugenia Portillo, Guillermo Ezpeleta, Jesús Castilla
Objective
We aimed to estimate autumn 2023 COVID-19 vaccine effectiveness (CVE) in preventing hospitalizations due to COVID-19 until September 2024.
Methods
We performed a test-negative case–control study nested in the cohort of adults aged ≥ 45 years with indication of autumn 2023 COVID-19 vaccination in Navarre, Spain. The study included patients hospitalized for severe acute respiratory infection (SARI) and tested by polymerase chain reaction between October 2023 and September 2024. The COVID-19 vaccination statuses in the current and previous seasons were compared between confirmed COVID-19 cases and test-negative controls. CVE was estimated as (1 − adjusted odds ratio) × 100.
Results
Of 4051 SARI hospitalized patients included in the study, 474 (12%) were confirmed for COVID-19. CVE to prevent COVID-19 hospitalizations was 32% (95% confidence interval [CI], 11%–48%) on average for the year and 38% (95% CI, 17%–54%) among people aged ≥ 65 years. However, estimates for current-season vaccination were 51% (95% CI, 30%–66%), 50% (95% CI, 16%–70%), and 0% (95% CI, −42% to 30%) for 7 to 89, 90 to 179, and ≥ 180 days between vaccination and COVID-19 diagnosis, respectively. The residual effect of previous-season vaccination was not statistically significant (14%; 95% CI, −20% to 39%). CVE was moderate in preventing COVID-19 hospitalizations between October 2023 and March 2024 (50%; 95% CI, 28%–65%), and null between April and September 2024 (6%; 95% CI, −41% to 38%). The vaccine averted 19% of COVID-19 hospitalizations. On average, 963 doses of vaccine were necessary to prevent one COVID-19 hospitalization.
Conclusions
CVE was moderate in preventing COVID-19 hospitalizations during the 2023–2024 season, but decreased 6 months after vaccination.
{"title":"Effectiveness and Impact of Autumn 2023 COVID-19 Vaccination in Preventing Hospitalizations in Navarre, Spain, October 2023 to September 2024","authors":"Iván Martínez-Baz, Camino Trobajo-Sanmartín, Miguel Fernández-Huerta, Ana Navascués, Aitziber Echeverria, Nerea Egüés, Noelia Vera-Punzano, María Eugenia Portillo, Guillermo Ezpeleta, Jesús Castilla","doi":"10.1111/irv.70163","DOIUrl":"https://doi.org/10.1111/irv.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to estimate autumn 2023 COVID-19 vaccine effectiveness (CVE) in preventing hospitalizations due to COVID-19 until September 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a test-negative case–control study nested in the cohort of adults aged ≥ 45 years with indication of autumn 2023 COVID-19 vaccination in Navarre, Spain. The study included patients hospitalized for severe acute respiratory infection (SARI) and tested by polymerase chain reaction between October 2023 and September 2024. The COVID-19 vaccination statuses in the current and previous seasons were compared between confirmed COVID-19 cases and test-negative controls. CVE was estimated as (1 − adjusted odds ratio) × 100.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4051 SARI hospitalized patients included in the study, 474 (12%) were confirmed for COVID-19. CVE to prevent COVID-19 hospitalizations was 32% (95% confidence interval [CI], 11%–48%) on average for the year and 38% (95% CI, 17%–54%) among people aged ≥ 65 years. However, estimates for current-season vaccination were 51% (95% CI, 30%–66%), 50% (95% CI, 16%–70%), and 0% (95% CI, −42% to 30%) for 7 to 89, 90 to 179, and ≥ 180 days between vaccination and COVID-19 diagnosis, respectively. The residual effect of previous-season vaccination was not statistically significant (14%; 95% CI, −20% to 39%). CVE was moderate in preventing COVID-19 hospitalizations between October 2023 and March 2024 (50%; 95% CI, 28%–65%), and null between April and September 2024 (6%; 95% CI, −41% to 38%). The vaccine averted 19% of COVID-19 hospitalizations. On average, 963 doses of vaccine were necessary to prevent one COVID-19 hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CVE was moderate in preventing COVID-19 hospitalizations during the 2023–2024 season, but decreased 6 months after vaccination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>The current panzootic caused by the highly pathogenic avian influenza virus A(H5N1) (hereafter, H5N1) is having devastating effects on animal and ecosystem health; the virus has spread globally, causing alarming mortalities in a wide range of domestic and wild animals [<span>1</span>]. By early 2024, at least 50 mammal species had been reported infected by H5N1, with massive mortalities in some cases; viral mutations suggest the virus is adapting to infect mammals [<span>2</span>]. This epidemiological situation puts humans at risk due to the potential emergence of a new viral variant capable of triggering a new pandemic. Here, we provide a global update on mammals infected by H5N1 up to July 2025 following the methodology previously used by Plaza et al. [<span>2</span>], which is based on a search of scientific literature and diverse global databases.</p><p>We found that between March 2024 and July 2025, 24 new species were recorded as infected, representing almost a 50% increase in the number of species (Figure 1A,B). The current 74 mammalian species known to be infected by this virus include domestic, synanthropic (i.e., wild species that live in human-modified environments and obtain benefits from humans), and wild species (Figure 1A). Humans use some of these species for productive purposes, such as breeding or harvesting for fur and food (Figure 1A), and several may act as mixing vessels (Figure 1A). Even considering the figures are underestimations [<span>1</span>], the Mustelidae family is the most affected (more than 50,000 cases, mostly in captivity for fur production), followed by the families Otariidae (> 24,000 cases, in the wild), Phocidae (> 18,000 cases, in the wild), Canidae (> 11,000 cases, mostly in captivity for fur production), and Bovidae (> 1000 cases, in dairy production) (Figure 1A).</p><p>The number of mammalian species infected by this zoonotic pathogen and the number of cases are rapidly increasing (Figure 1A,B). Although increased testing may have influenced this result, the almost 50% rise in species in just over a year is highly concerning. Some species pose a significant risk to humans due to their large populations, close proximity to human settlements, and potential role as mixing vessels.</p><p>Surveillance for high-risk species (i.e., mixing vessels with large populations living near humans) should be a global priority. The lack of information about the H5N1 epidemiological situation in some regions (e.g., some areas of the Global South) should be addressed by promoting surveillance programs and providing funds and technology [<span>1</span>].</p><p>The most affected mammalian species are those used by humans, particularly in intensive production systems. This makes management of the H5N1 spread challenging because the virus is strongly associated with our unsustainable ways of living and production methods [<span>6</span>]. If this panzootic is not addressed from a holistic, ecological, producti
目前由高致病性禽流感病毒A(H5N1)（以下简称H5N1）引起的流行性传染病正在对动物和生态系统健康造成破坏性影响；该病毒已在全球传播，在大量家畜和野生动物中造成惊人的死亡。到2024年初，据报告至少有50种哺乳动物感染了H5N1，在某些情况下造成大量死亡；病毒突变表明病毒正在适应感染哺乳动物。由于可能出现能够引发新的大流行的新病毒变体，这种流行病学情况使人类处于危险之中。在此，我们根据Plaza等人先前使用的方法（基于对科学文献和多种全球数据库的搜索），提供了截至2025年7月感染H5N1的哺乳动物的全球最新情况。我们发现，在2024年3月至2025年7月之间，有24个新物种被记录为感染，这意味着物种数量增加了近50%（图1A，B）。目前已知感染该病毒的74种哺乳动物包括家养、合栖（即生活在人类改造的环境中并从人类获益的野生物种）和野生物种（图1A）。人类将其中一些物种用于生产目的，例如繁殖或收获皮毛和食物（图1A），还有一些可能充当混合容器（图1A）。即使考虑到这些数字被低估了，野马科也是受影响最大的（超过50,000例，主要是为了生产毛皮而圈养），其次是牛科（> 24,000例，在野外），Phocidae （> 18,000例，在野外），犬科（> 11,000例，主要是为了生产毛皮而圈养）和牛科（>； 1000例，在乳制品生产中）（图1A）。感染这种人畜共患病原体的哺乳动物种类数量和病例数量正在迅速增加（图1A、B）。尽管越来越多的检测可能影响了这一结果，但在短短一年多的时间里，物种数量几乎增加了50%，这是非常令人担忧的。一些物种由于其庞大的种群数量，靠近人类住区，以及作为混合容器的潜在作用，对人类构成重大风险。对高风险物种的监测（即与居住在人类附近的大量种群混合的船只）应成为全球优先事项。一些地区（例如，全球南方的一些地区）缺乏关于H5N1流行病学情况的信息，应通过促进监测规划和提供资金和技术来解决。受影响最严重的哺乳动物是人类使用的哺乳动物，特别是在集约化生产系统中。这使得管理H5N1传播具有挑战性，因为该病毒与我们不可持续的生活方式和生产方式密切相关。如果不能从整体、生态、生产和跨学科的角度来解决这一流行病，那么只能采取姑息性行动，在减少这种病原体的负面影响方面效果有限。H5N1已经在全球传播——不仅在鸟类中，而且在哺乳动物中；现在是时候尽我们所有的努力来减少它对野生和家养物种的影响，以及它对人类的传播。Pablo Plaza：概念化，数据管理，调查，写作-原稿，写作-审查和编辑，方法，资金获取。Sergio A. Lambertucci：概念化，方法论，数据管理，调查，项目管理，资金获取，写作-原稿，写作-审查和编辑，监督。作者没有什么可报告的。作者没有什么可报告的。
{"title":"Update on H5N1 Panzootic: Infected Mammal Species Increase by Almost 50% in Just Over a Year","authors":"Pablo Plaza, Sergio A. Lambertucci","doi":"10.1111/irv.70159","DOIUrl":"https://doi.org/10.1111/irv.70159","url":null,"abstract":"<p>The current panzootic caused by the highly pathogenic avian influenza virus A(H5N1) (hereafter, H5N1) is having devastating effects on animal and ecosystem health; the virus has spread globally, causing alarming mortalities in a wide range of domestic and wild animals [<span>1</span>]. By early 2024, at least 50 mammal species had been reported infected by H5N1, with massive mortalities in some cases; viral mutations suggest the virus is adapting to infect mammals [<span>2</span>]. This epidemiological situation puts humans at risk due to the potential emergence of a new viral variant capable of triggering a new pandemic. Here, we provide a global update on mammals infected by H5N1 up to July 2025 following the methodology previously used by Plaza et al. [<span>2</span>], which is based on a search of scientific literature and diverse global databases.</p><p>We found that between March 2024 and July 2025, 24 new species were recorded as infected, representing almost a 50% increase in the number of species (Figure 1A,B). The current 74 mammalian species known to be infected by this virus include domestic, synanthropic (i.e., wild species that live in human-modified environments and obtain benefits from humans), and wild species (Figure 1A). Humans use some of these species for productive purposes, such as breeding or harvesting for fur and food (Figure 1A), and several may act as mixing vessels (Figure 1A). Even considering the figures are underestimations [<span>1</span>], the Mustelidae family is the most affected (more than 50,000 cases, mostly in captivity for fur production), followed by the families Otariidae (> 24,000 cases, in the wild), Phocidae (> 18,000 cases, in the wild), Canidae (> 11,000 cases, mostly in captivity for fur production), and Bovidae (> 1000 cases, in dairy production) (Figure 1A).</p><p>The number of mammalian species infected by this zoonotic pathogen and the number of cases are rapidly increasing (Figure 1A,B). Although increased testing may have influenced this result, the almost 50% rise in species in just over a year is highly concerning. Some species pose a significant risk to humans due to their large populations, close proximity to human settlements, and potential role as mixing vessels.</p><p>Surveillance for high-risk species (i.e., mixing vessels with large populations living near humans) should be a global priority. The lack of information about the H5N1 epidemiological situation in some regions (e.g., some areas of the Global South) should be addressed by promoting surveillance programs and providing funds and technology [<span>1</span>].</p><p>The most affected mammalian species are those used by humans, particularly in intensive production systems. This makes management of the H5N1 spread challenging because the virus is strongly associated with our unsustainable ways of living and production methods [<span>6</span>]. If this panzootic is not addressed from a holistic, ecological, producti","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magda Bucholc, Mark G. O'Doherty, Declan T. Bradley
Background
We evaluated the effectiveness of the influenza vaccine programme against infection among emergency hospital admissions with respiratory conditions in Northern Ireland during the 2023/2024 influenza season.
Methods
Using a test-negative design, we compared the odds of vaccination between patients who tested positive (cases) and negative (controls) for laboratory-confirmed influenza, adjusting for confounders. VE was stratified by age group, sex and time since vaccination.
Results
We included 2368 hospitalised patients, of whom 1740 (73.5%) were influenza positive. Among these, 1703 (97.9%) were influenza A and 37 (2.1%) were influenza B. Of the influenza A-positive specimens, 84 were A(H1), 268 A(H3) and 1351 were untyped influenza A. VE against all laboratory-confirmed influenza was 47.5% (95% CI: 31.3%–60.1%), including 65.2% (95% CI: 44.2%–78.6%) in children aged 2–17, 46% (95% CI: 7.8%–68.2%) in adults 18–64 and 39.5% (95% CI: 4.8%–62.1%) in adults aged 65 and over. VE against infection for influenza A was 45.8% (95% CI: 25.1%–61%) in all age groups, but 64.7% (95% CI: 42.6%–78.6%) among children aged 2–17, 43.9% (95% CI: 3.7%–67.1%) among adults aged 18–64 years old and 39.6% (95% CI: 5%–62.1%) in adults aged ≥ 65 years. Being vaccinated was associated with 44.2% (95% CI: −13.3%-73.1%) and 37.9% (95% CI: 5.5%–59.5%) reduced odds of influenza A(H1) and A(H3)-associated community-acquired emergency admissions. VE against infection for influenza B was 87.2% (95% CI: 43.1%–98.3%). VE was highest within 2–8 weeks of vaccination at 67.5% (95% CI: 42.7%–81.7%) and declined to 41.2% (95% CI: 14.8%–59.5%) at 9–16 weeks.
Conclusions
Influenza vaccines provided protection against influenza-associated illness across age groups during the 2023/2024 influenza season.
{"title":"Influenza Vaccine Effectiveness During the 2023/2024 Season: A Test-Negative Case–Control Study Among Emergency Hospital Admissions With Respiratory Conditions in Northern Ireland","authors":"Magda Bucholc, Mark G. O'Doherty, Declan T. Bradley","doi":"10.1111/irv.70149","DOIUrl":"10.1111/irv.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We evaluated the effectiveness of the influenza vaccine programme against infection among emergency hospital admissions with respiratory conditions in Northern Ireland during the 2023/2024 influenza season.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a test-negative design, we compared the odds of vaccination between patients who tested positive (cases) and negative (controls) for laboratory-confirmed influenza, adjusting for confounders. VE was stratified by age group, sex and time since vaccination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 2368 hospitalised patients, of whom 1740 (73.5%) were influenza positive. Among these, 1703 (97.9%) were influenza A and 37 (2.1%) were influenza B. Of the influenza A-positive specimens, 84 were A(H1), 268 A(H3) and 1351 were untyped influenza A. VE against all laboratory-confirmed influenza was 47.5% (95% CI: 31.3%–60.1%), including 65.2% (95% CI: 44.2%–78.6%) in children aged 2–17, 46% (95% CI: 7.8%–68.2%) in adults 18–64 and 39.5% (95% CI: 4.8%–62.1%) in adults aged 65 and over. VE against infection for influenza A was 45.8% (95% CI: 25.1%–61%) in all age groups, but 64.7% (95% CI: 42.6%–78.6%) among children aged 2–17, 43.9% (95% CI: 3.7%–67.1%) among adults aged 18–64 years old and 39.6% (95% CI: 5%–62.1%) in adults aged ≥ 65 years. Being vaccinated was associated with 44.2% (95% CI: −13.3%-73.1%) and 37.9% (95% CI: 5.5%–59.5%) reduced odds of influenza A(H1) and A(H3)-associated community-acquired emergency admissions. VE against infection for influenza B was 87.2% (95% CI: 43.1%–98.3%). VE was highest within 2–8 weeks of vaccination at 67.5% (95% CI: 42.7%–81.7%) and declined to 41.2% (95% CI: 14.8%–59.5%) at 9–16 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Influenza vaccines provided protection against influenza-associated illness across age groups during the 2023/2024 influenza season.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gang Chen, Xiuchang Ma, Jinhuan Wu, Yi Yan, Wenxian Qian, Apeng Chen, Changhua Yi, Man Tian
Respiratory syncytial virus (RSV) is one of the leading causes of severe respiratory diseases in children, especially in infants. The immune responses induced by RSV infection are a fairly complex process that can contribute significantly to disease severity. Despite decades of research on RSV, many immune mechanisms remain to be explored. A full exploration of these immune responses can contribute to the discovery of new therapeutic and prophylactic approaches. Despite significant advancements in vaccine development and monoclonal antibody research, effective therapeutic options remain limited. This review focuses on how the immune system reacts when children contract the respiratory syncytial virus. We describe the biological characteristics of RSV, viral-cell interactions, immune evasion, innate immunity (including pattern recognition receptors and inflammatory cells), and adaptive immunity (including CD4+ and CD8+ T cells and humoral immune response). Understanding the complicated immune response to RSV infection is essential for developing effective interventions and vaccine developments. This review aims to deepen the understanding of the impact of Respiratory Syncytial Virus (RSV) on the immune system and to contribute to the advancement of practical therapeutic strategies.
{"title":"Host Immune Response to Respiratory Syncytial Virus Infection in Children","authors":"Gang Chen, Xiuchang Ma, Jinhuan Wu, Yi Yan, Wenxian Qian, Apeng Chen, Changhua Yi, Man Tian","doi":"10.1111/irv.70156","DOIUrl":"10.1111/irv.70156","url":null,"abstract":"<div>\u0000 \u0000 <p>Respiratory syncytial virus (RSV) is one of the leading causes of severe respiratory diseases in children, especially in infants. The immune responses induced by RSV infection are a fairly complex process that can contribute significantly to disease severity. Despite decades of research on RSV, many immune mechanisms remain to be explored. A full exploration of these immune responses can contribute to the discovery of new therapeutic and prophylactic approaches. Despite significant advancements in vaccine development and monoclonal antibody research, effective therapeutic options remain limited. This review focuses on how the immune system reacts when children contract the respiratory syncytial virus. We describe the biological characteristics of RSV, viral-cell interactions, immune evasion, innate immunity (including pattern recognition receptors and inflammatory cells), and adaptive immunity (including CD4+ and CD8+ T cells and humoral immune response). Understanding the complicated immune response to RSV infection is essential for developing effective interventions and vaccine developments. This review aims to deepen the understanding of the impact of Respiratory Syncytial Virus (RSV) on the immune system and to contribute to the advancement of practical therapeutic strategies.</p>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study compared the diagnostic accuracy of seven different commercial serological assays for COVID-19, using RT-PCR as the gold standard, through meta-analysis and indirect comparison.
Methods
Fifty-seven studies, published from November 2019 to June 2024, were included. The diagnostic performance of IgA, IgG, and total antibody assays for SARS-CoV-2 was assessed. The netmeta, rjags, and gemtc packages in R software were used for adjusted indirect comparison to calculate the relative diagnostic odds ratio (RDOR).
Results
The pooled diagnostic odds ratio (DOR) for Abbott SARS-CoV-2 IgG was 542.81, for Elecsys Anti-SARS-CoV-2 N was 1022.34, for Elecsys Anti-SARS-CoV-2 total was 1701.56, for Euroimmun Anti-SARS-CoV-2 IgA was 45.91, for Euroimmun Anti-SARS-CoV-2 S1-IgG was 190.45, for Euroimmun Anti-SARS-CoV-2 N-IgG was 82.63, and for LIAISON SARS-CoV-2 S1/S2 IgG was 178.73. The pooled DOR for IgG, IgA, and total antibody assays was 241.43, 45.91, and 1124.48. The pooled DOR for the antinucleocapsid antigen (anti-N) was 604.29; for the antidomain of viral spike protein (anti-S1) and the antirecombinant S1 and S2 (anti-S1/S2) antigens, the pooled DORs were 119.88 and 178.73. ECLIA and CMIA methods had superior diagnostic performance compared with CLIA and ELISA, with no significant difference between ECLIA and CMIA. Total antibody assays showed the highest accuracy, followed by IgG, with IgA performing least effectively.
Conclusions
Elecsys Anti-SARS-CoV-2 total and N assays had the best overall diagnostic test accuracy. The diagnostic efficacy of the anti-N total, IgG antibodies was statistically significantly higher than that of anti-S IgG and IgA antibodies for COVID-19.
目的本研究以RT-PCR为金标准，通过meta分析和间接比较，比较7种不同的商用COVID-19血清学检测方法的诊断准确性。方法纳入2019年11月至2024年6月发表的57项研究。评估IgA、IgG和总抗体检测对SARS-CoV-2的诊断效果。采用R软件中的netmeta、rjags和gemtc软件包进行调整间接比较，计算相对诊断优势比（RDOR）。结果Abbott - cov -2 IgG的诊断优势比（DOR）为542.81，Elecsys anti - cov -2 N的诊断优势比为1022.34，Elecsys anti - cov -2 total的诊断优势比为1701.56，euroimmune anti - cov -2 IgA的诊断优势比为45.91，euroimmune anti - cov -2 S1-IgG的诊断优势比为190.45，euroimmune anti - cov -2 N-IgG的诊断优势比为82.63，LIAISON SARS-CoV-2 S1/S2 IgG的诊断优势比为178.73。IgG、IgA和总抗体检测的合并DOR分别为241.43、45.91和1124.48。抗核衣壳抗原（anti-N）的聚合DOR为604.29；病毒刺突蛋白反结构域（anti-S1）和抗重组抗原S1和S2 （anti-S1/S2）的合并DORs分别为119.88和178.73。ECLIA和CMIA方法的诊断效果优于CLIA和ELISA， ECLIA和CMIA方法的诊断效果无显著性差异。总抗体测定的准确性最高，IgG次之，IgA最低。结论Elecsys anti - cov -2总抗体和N抗体具有较好的综合诊断准确性。抗n总抗体、IgG抗体对COVID-19的诊断效能显著高于抗s IgG和IgA抗体。
{"title":"An Indirect Comparison of Diagnostic Accuracy for Seven Different SARS-CoV-2 Serological Assays: A Meta-Analysis and Adjusted Indirect Comparison of Diagnostic Test Accuracy","authors":"Minjie Zhang, Ying Zhao, Lijiang Fang, Weiwei Liang","doi":"10.1111/irv.70155","DOIUrl":"https://doi.org/10.1111/irv.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study compared the diagnostic accuracy of seven different commercial serological assays for COVID-19, using RT-PCR as the gold standard, through meta-analysis and indirect comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-seven studies, published from November 2019 to June 2024, were included. The diagnostic performance of IgA, IgG, and total antibody assays for SARS-CoV-2 was assessed. The netmeta, rjags, and gemtc packages in R software were used for adjusted indirect comparison to calculate the relative diagnostic odds ratio (RDOR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The pooled diagnostic odds ratio (DOR) for Abbott SARS-CoV-2 IgG was 542.81, for Elecsys Anti-SARS-CoV-2 N was 1022.34, for Elecsys Anti-SARS-CoV-2 total was 1701.56, for Euroimmun Anti-SARS-CoV-2 IgA was 45.91, for Euroimmun Anti-SARS-CoV-2 S1-IgG was 190.45, for Euroimmun Anti-SARS-CoV-2 N-IgG was 82.63, and for LIAISON SARS-CoV-2 S1/S2 IgG was 178.73. The pooled DOR for IgG, IgA, and total antibody assays was 241.43, 45.91, and 1124.48. The pooled DOR for the antinucleocapsid antigen (anti-N) was 604.29; for the antidomain of viral spike protein (anti-S1) and the antirecombinant S1 and S2 (anti-S1/S2) antigens, the pooled DORs were 119.88 and 178.73. ECLIA and CMIA methods had superior diagnostic performance compared with CLIA and ELISA, with no significant difference between ECLIA and CMIA. Total antibody assays showed the highest accuracy, followed by IgG, with IgA performing least effectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Elecsys Anti-SARS-CoV-2 total and N assays had the best overall diagnostic test accuracy. The diagnostic efficacy of the anti-N total, IgG antibodies was statistically significantly higher than that of anti-S IgG and IgA antibodies for COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ismaila Shittu, Daniel B. Cummings, John T. Groves, Alex G. Hagan, Gregory C. Gray
<p>Bovine respiratory disease complex (BRDC) is a major disease problem in cattle production systems. Numerous pathogens have been implicated as causing BRDC, including the recently discovered influenza D virus (IDV) [<span>1</span>]. IDV has been found to be highly enzootic in cattle across multiple continents [<span>1, 2</span>], and there is some evidence of spillover to livestock workers [<span>3, 4</span>]. In March 2024, unprecedented outbreaks of influenza A virus (IAV) H5N1 clade 2.3.4.4b were reported in the United States [<span>5</span>] with occasional spillover to dairy and poultry workers [<span>6, 7</span>]. Given the occupational threats of both IDV and IAV H5N1, we sought to assess the dynamics of antibodies to IAV H5N1 and IDV in farm workers and cattle.</p><p>As part of our One Health surveillance initiative in the United States and Mexico [<span>6, 8</span>], between April 2024 and May 2025 we enrolled a total of seven dairy and beef cattle farms in Indiana (<i>n</i> = 1), Kentucky (<i>n</i> = 3), and Texas (<i>n</i> = 2) (Table 1). Our visits to these farms took place on four separate occasions, permitting us to prospectively follow the farms. We obtained informed consent from every farm worker who participated in the study. Based on availability, we collected 5 to 10 mL of blood from both the cattle and the farm workers through venipuncture using a plain vacutainer tube (BD, Franklin Lakes, NJ, USA). After collection, the blood samples were centrifuged at 600 <i>g</i> for 15 min, and the serum was harvested and stored in microtubes at −20°C. Throughout the four visits, we collected 270 serum samples, which comprised 142 samples from cattle and 128 samples from farm workers (Table 1). Ethical approval for the study was granted by the University of Texas Medical Branch's Institutional Review Board (23-0085).</p><p>To determine the presence of neutralizing antibodies (NAbs) against IAV-H5 and IDV in both the cattle and farm workers sera, we conducted microneutralization (MN) assays. Briefly, serum samples were treated overnight (18–20 h) with Receptor Destroying Enzyme II (RDE; Denka Seiken, Tokyo, Japan) according to the manufacturer's instructions. This treatment was necessary to eliminate nonspecific inhibitors that could interfere with the assay. Starting with a dilution of 1:20 to 1:2560 RDE-treated sera, we used a recombinant H5N1 virus (rg-A/bald eagle/Florida/W22-134-OP/2022 of clade 2.3.4.4b) and a bovine-origin IDV strain (D/Bovine/Kansas/1-35/2010) on a monolayer of Madin-Darby canine kidney (MDCK; ATCC cat. no. CRL-CCL34) cells in 96-well plates following standard procedures with minor modifications [<span>4, 9</span>].</p><p>As measured by the MN assay, none of the enrolled beef cattle farm workers had NAbs antibodies to IAV-H5 during any of the four visits to the farms in Indiana, Kentucky, and Texas, except for the first visit to Texas (Table 1). During this visit, two dairy farm workers were found to have NAbs to
{"title":"Low Levels of Neutralizing Antibodies to Influenza A (H5N1) and D Viruses Among Cattle and Cattle Workers on US Farms, 2024–2025","authors":"Ismaila Shittu, Daniel B. Cummings, John T. Groves, Alex G. Hagan, Gregory C. Gray","doi":"10.1111/irv.70162","DOIUrl":"https://doi.org/10.1111/irv.70162","url":null,"abstract":"<p>Bovine respiratory disease complex (BRDC) is a major disease problem in cattle production systems. Numerous pathogens have been implicated as causing BRDC, including the recently discovered influenza D virus (IDV) [<span>1</span>]. IDV has been found to be highly enzootic in cattle across multiple continents [<span>1, 2</span>], and there is some evidence of spillover to livestock workers [<span>3, 4</span>]. In March 2024, unprecedented outbreaks of influenza A virus (IAV) H5N1 clade 2.3.4.4b were reported in the United States [<span>5</span>] with occasional spillover to dairy and poultry workers [<span>6, 7</span>]. Given the occupational threats of both IDV and IAV H5N1, we sought to assess the dynamics of antibodies to IAV H5N1 and IDV in farm workers and cattle.</p><p>As part of our One Health surveillance initiative in the United States and Mexico [<span>6, 8</span>], between April 2024 and May 2025 we enrolled a total of seven dairy and beef cattle farms in Indiana (<i>n</i> = 1), Kentucky (<i>n</i> = 3), and Texas (<i>n</i> = 2) (Table 1). Our visits to these farms took place on four separate occasions, permitting us to prospectively follow the farms. We obtained informed consent from every farm worker who participated in the study. Based on availability, we collected 5 to 10 mL of blood from both the cattle and the farm workers through venipuncture using a plain vacutainer tube (BD, Franklin Lakes, NJ, USA). After collection, the blood samples were centrifuged at 600 <i>g</i> for 15 min, and the serum was harvested and stored in microtubes at −20°C. Throughout the four visits, we collected 270 serum samples, which comprised 142 samples from cattle and 128 samples from farm workers (Table 1). Ethical approval for the study was granted by the University of Texas Medical Branch's Institutional Review Board (23-0085).</p><p>To determine the presence of neutralizing antibodies (NAbs) against IAV-H5 and IDV in both the cattle and farm workers sera, we conducted microneutralization (MN) assays. Briefly, serum samples were treated overnight (18–20 h) with Receptor Destroying Enzyme II (RDE; Denka Seiken, Tokyo, Japan) according to the manufacturer's instructions. This treatment was necessary to eliminate nonspecific inhibitors that could interfere with the assay. Starting with a dilution of 1:20 to 1:2560 RDE-treated sera, we used a recombinant H5N1 virus (rg-A/bald eagle/Florida/W22-134-OP/2022 of clade 2.3.4.4b) and a bovine-origin IDV strain (D/Bovine/Kansas/1-35/2010) on a monolayer of Madin-Darby canine kidney (MDCK; ATCC cat. no. CRL-CCL34) cells in 96-well plates following standard procedures with minor modifications [<span>4, 9</span>].</p><p>As measured by the MN assay, none of the enrolled beef cattle farm workers had NAbs antibodies to IAV-H5 during any of the four visits to the farms in Indiana, Kentucky, and Texas, except for the first visit to Texas (Table 1). During this visit, two dairy farm workers were found to have NAbs to","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Besfort Kryeziu, Sandra Cohuet, Ariana Kalaveshi-Osmani, Zana Kaçaniku-Deva, Pranvera Kaçaniku-Gunga, Iris Finci, Miguel Angel Sanchez, James Humphreys, Naser Ramadani, Edita Haxhiu, Kostas Danis, Angela M. C. Rose, Isme Humolli, Mark A. Katz
Background
Few studies have evaluated COVID-19 vaccine effectiveness (VE) in middle-income countries, particularly in eastern Europe. We aimed to estimate COVID-19 VE against SARS-CoV-2-confirmed hospitalizations and severe outcomes in Kosovo.
Methods
We conducted a test-negative case–control study using data from Kosovo's severe acute respiratory infection (SARI) sentinel surveillance system from January 2022 to June 2024. We enrolled adult patients aged ≥ 18 years hospitalized with SARI. From all patients, we collected clinical data, vaccination history, and a nasopharyngeal specimen, which was tested for SARS-CoV-2 using RT-PCR. SARS-CoV-2-positive patients were cases; those testing negative were controls. We estimated VE overall and against severe outcomes (requiring oxygen, intensive care admission, or in-hospital death) using logistic regression, adjusting for age, sex, and comorbidities, calculating VE as (1–adjusted odds ratio) × 100.
Results
We included 564 SARI patients; 218 (39%) tested positive for SARS-CoV-2. Overall, 24% of SARI patients had received at least one COVID-19 vaccine dose in the previous 12 months. VE against SARS-CoV-2-confirmed SARI hospitalization among all adults was 72% (95% CI: 30%–89%) at 14–179-day postvaccination, and 26% (95% CI: −33%–59%) at 180–364 days. In adults ≥ 60 years, VE was 52% (95% CI:−31%–82%) at 14–179-day postvaccination, and −36% (95% CI: −190%–36%) at 180–364 days. VE against severe outcomes was 67% (95% CI: −14%–91%) at 14–179 days, and 17% (95% CI:−111%–67%) at 180–364 days.
Conclusions
Our findings suggest that COVID-19 vaccination in Kosovo offered substantial protection against hospitalization and severe outcomes within 6 months, though confidence intervals were wide for some subgroups. Effectiveness waned after 6 months, highlighting the need for periodic booster doses.
{"title":"COVID-19 Vaccine Effectiveness Against Hospitalizations and Severe Outcomes in Kosovo, 2022–2024: A Test-Negative Case–Control Study","authors":"Besfort Kryeziu, Sandra Cohuet, Ariana Kalaveshi-Osmani, Zana Kaçaniku-Deva, Pranvera Kaçaniku-Gunga, Iris Finci, Miguel Angel Sanchez, James Humphreys, Naser Ramadani, Edita Haxhiu, Kostas Danis, Angela M. C. Rose, Isme Humolli, Mark A. Katz","doi":"10.1111/irv.70152","DOIUrl":"https://doi.org/10.1111/irv.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Few studies have evaluated COVID-19 vaccine effectiveness (VE) in middle-income countries, particularly in eastern Europe. We aimed to estimate COVID-19 VE against SARS-CoV-2-confirmed hospitalizations and severe outcomes in Kosovo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a test-negative case–control study using data from Kosovo's severe acute respiratory infection (SARI) sentinel surveillance system from January 2022 to June 2024. We enrolled adult patients aged ≥ 18 years hospitalized with SARI. From all patients, we collected clinical data, vaccination history, and a nasopharyngeal specimen, which was tested for SARS-CoV-2 using RT-PCR. SARS-CoV-2-positive patients were cases; those testing negative were controls. We estimated VE overall and against severe outcomes (requiring oxygen, intensive care admission, or in-hospital death) using logistic regression, adjusting for age, sex, and comorbidities, calculating VE as (1–adjusted odds ratio) × 100.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 564 SARI patients; 218 (39%) tested positive for SARS-CoV-2. Overall, 24% of SARI patients had received at least one COVID-19 vaccine dose in the previous 12 months. VE against SARS-CoV-2-confirmed SARI hospitalization among all adults was 72% (95% CI: 30%–89%) at 14–179-day postvaccination, and 26% (95% CI: −33%–59%) at 180–364 days. In adults ≥ 60 years, VE was 52% (95% CI:−31%–82%) at 14–179-day postvaccination, and −36% (95% CI: −190%–36%) at 180–364 days. VE against severe outcomes was 67% (95% CI: −14%–91%) at 14–179 days, and 17% (95% CI:−111%–67%) at 180–364 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that COVID-19 vaccination in Kosovo offered substantial protection against hospitalization and severe outcomes within 6 months, though confidence intervals were wide for some subgroups. Effectiveness waned after 6 months, highlighting the need for periodic booster doses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susanne Gerda Værnø, Francisco Oteiza, Maren Gillebo, Lise Beier Havdal, David Ngaruiya Mwaura, Øyvind Husby, Oddvar Solli, Kristian Lie, Christoffer Bugge
Background
Respiratory syncytial virus (RSV) is recognized as the primary cause of hospitalizations among children with lower respiratory tract infections in developed countries, placing a significant burden on both patients and healthcare systems. The efficacy, safety, and immunogenicity of maternal vaccination with the novel RSVpreF vaccine have been evaluated in a Phase III clinical trial, showing a decreased risk of severe infection in infants. Our study assesses the cost-effectiveness of the RSVpreF vaccine and seasonal variation of costs in a Norwegian setting.
Methods
A Markov model was used to estimate the clinical outcomes, costs, and quality-adjusted life years of a hypothetical cohort of Norwegian infants born during a single RSV season. A seasonal vaccination program with RSVpreF vaccine was compared to no intervention by means of an incremental cost-effectiveness ratio (ICER) from extended healthcare and societal perspectives.
Results
A seasonal maternal vaccination program with RSVpreF in Norway is cost-effective from both a healthcare and societal perspective, given the Norwegian willingness-to-pay threshold range. The program could prevent 27% of the yearly RSV-associated hospital admissions, as well as 14% and 24% of the yearly RSV-associated primary care and outpatient visits. A 10% increase/decrease in hospitalization costs during the winter/summer months leads to a 26% reduction in the ICER from a healthcare perspective and turns the intervention into a dominant strategy from a societal one.
Conclusions
Based on the RSVpreF vaccine's list price in Norway, the seasonal vaccination program is cost-effective from both the healthcare and societal perspectives, considering a willingness-to-pay threshold of 500,000 NOK.
{"title":"Cost-Effectiveness Analysis of a Maternal Vaccination Program Against Respiratory Syncytial Virus in Norway","authors":"Susanne Gerda Værnø, Francisco Oteiza, Maren Gillebo, Lise Beier Havdal, David Ngaruiya Mwaura, Øyvind Husby, Oddvar Solli, Kristian Lie, Christoffer Bugge","doi":"10.1111/irv.70161","DOIUrl":"https://doi.org/10.1111/irv.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respiratory syncytial virus (RSV) is recognized as the primary cause of hospitalizations among children with lower respiratory tract infections in developed countries, placing a significant burden on both patients and healthcare systems. The efficacy, safety, and immunogenicity of maternal vaccination with the novel RSVpreF vaccine have been evaluated in a Phase III clinical trial, showing a decreased risk of severe infection in infants. Our study assesses the cost-effectiveness of the RSVpreF vaccine and seasonal variation of costs in a Norwegian setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Markov model was used to estimate the clinical outcomes, costs, and quality-adjusted life years of a hypothetical cohort of Norwegian infants born during a single RSV season. A seasonal vaccination program with RSVpreF vaccine was compared to no intervention by means of an incremental cost-effectiveness ratio (ICER) from extended healthcare and societal perspectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A seasonal maternal vaccination program with RSVpreF in Norway is cost-effective from both a healthcare and societal perspective, given the Norwegian willingness-to-pay threshold range. The program could prevent 27% of the yearly RSV-associated hospital admissions, as well as 14% and 24% of the yearly RSV-associated primary care and outpatient visits. A 10% increase/decrease in hospitalization costs during the winter/summer months leads to a 26% reduction in the ICER from a healthcare perspective and turns the intervention into a dominant strategy from a societal one.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Based on the RSVpreF vaccine's list price in Norway, the seasonal vaccination program is cost-effective from both the healthcare and societal perspectives, considering a willingness-to-pay threshold of 500,000 NOK.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nelson J. Alvis-Zakzuk, Paula Couto, Jorge H. Jara, Miguel Descalzo, Marc Rondy, Stefano Tempia, Andrea Vicari
Objective
The objective of this study is to summarize the state of knowledge on the economic burden and cost of illness due to influenza, SARS-CoV-2, respiratory syncytial virus (RSV), and other respiratory viruses (ORV) in Latin America and the Caribbean (LAC).
Methods
We performed a scoping review across three databases (PubMed-Medline, Scielo, and Embase) without time restriction, including economic burden and cost-of-illness studies. We extracted and analyzed data on publication year, population, study type, perspective, costing techniques, and settings. We reported absolute and relative frequencies to summarize the results. Economic burden estimates were divided by the gross domestic product (GDP) for each country. Costs were converted into 2022 international dollars (PPP).
Results
Overall, 2638 articles were retrieved; we included 44 full texts from 16 LAC countries. Twenty-four (54.5%) studies focused on influenza, 16 (36.4%) on SARS-CoV-2, 3 (6.8%) on RSV, and 1 on ORV. Twenty two (50.0%) focused on cost-effectiveness (related to vaccination)/cost–benefit analysis, and 17 (38.6%) focused on cost of illness. Most studies (n = 33, 75.0%) were conducted from the third-party perspective. Fifty percent of the studies used a bottom-up costing technique and 29.6% top-down. Influenza direct medical costs ranged from I$6.6–I$300.3 for outpatients and I$62.8–I$222,920 for inpatients; for RSV from I$68.3–I$1292; and for SARS-CoV-2 between I$69.9 and I$38,039. The total annual costs of the influenza economic burden ranged between 0.0003% and 1.33% of the GDP.
Conclusion
This study showed variability in costing methods, perspectives, and types of studies among LAC countries. This variability underscores the need for standardized methodologies in future cost studies to ensure comparability and reliability of results.
{"title":"Economic Burden of Respiratory Viruses in Latin America and the Caribbean (LAC): A Scoping Literature Review","authors":"Nelson J. Alvis-Zakzuk, Paula Couto, Jorge H. Jara, Miguel Descalzo, Marc Rondy, Stefano Tempia, Andrea Vicari","doi":"10.1111/irv.70148","DOIUrl":"https://doi.org/10.1111/irv.70148","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study is to summarize the state of knowledge on the economic burden and cost of illness due to influenza, SARS-CoV-2, respiratory syncytial virus (RSV), and other respiratory viruses (ORV) in Latin America and the Caribbean (LAC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a scoping review across three databases (PubMed-Medline, Scielo, and Embase) without time restriction, including economic burden and cost-of-illness studies. We extracted and analyzed data on publication year, population, study type, perspective, costing techniques, and settings. We reported absolute and relative frequencies to summarize the results. Economic burden estimates were divided by the gross domestic product (GDP) for each country. Costs were converted into 2022 international dollars (PPP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 2638 articles were retrieved; we included 44 full texts from 16 LAC countries. Twenty-four (54.5%) studies focused on influenza, 16 (36.4%) on SARS-CoV-2, 3 (6.8%) on RSV, and 1 on ORV. Twenty two (50.0%) focused on cost-effectiveness (related to vaccination)/cost–benefit analysis, and 17 (38.6%) focused on cost of illness. Most studies (<i>n</i> = 33, 75.0%) were conducted from the third-party perspective. Fifty percent of the studies used a bottom-up costing technique and 29.6% top-down. Influenza direct medical costs ranged from I$6.6–I$300.3 for outpatients and I$62.8–I$222,920 for inpatients; for RSV from I$68.3–I$1292; and for SARS-CoV-2 between I$69.9 and I$38,039. The total annual costs of the influenza economic burden ranged between 0.0003% and 1.33% of the GDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study showed variability in costing methods, perspectives, and types of studies among LAC countries. This variability underscores the need for standardized methodologies in future cost studies to ensure comparability and reliability of results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13544,"journal":{"name":"Influenza and Other Respiratory Viruses","volume":"19 9","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/irv.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144990779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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