Comment on Postma et al. Predicted Public Health and Economic Impact of Respiratory Syncytial Virus Vaccination with Variable Duration of Protection for Adults ≥60 Years in Belgium. Vaccines 2023, 11, 990

Abstract

Presently, there are at least five important vaccine producers that have already launched or intend to launch a new vaccine designed to prevent infections caused by the Respiratory Syncytial Virus (RSV), which is highly prevalent in the youngest as well as the oldest age groups [...]

Reply to Standaert, B. Comment on “Postma et al. Predicted Public Health and Economic Impact of Respiratory Syncytial Virus Vaccination with Variable Duration of Protection for Adults ≥60 Years in Belgium”

“…We agree with some of the concerns raised by Standaert [1]. In particular, with regard to age stratification, despite the efforts in one of the scenario analyses, there are still limitations in acquiring more accurate data by age subgroups (including RSV epidemiology, vaccine effectiveness, and productivity loss).…”

“…We have read the commentary from Baudouin Standaert [1] on our work published recently in this journal on the public health and economic impact of potential Respiratory Syncytial Virus (RSV) vaccination [2]. The objective of Postma et al [2] was to estimate the public health and economic impact of the introduction of an RSV vaccine for older adults via a modeling study, and not to conduct a cost-effectiveness analysis (CEA) nor to estimate an acceptable vaccine price.…”

“…The authors did not conduct a formal CEA. Therefore, vaccine acquisition and administration costs, typical CEA outcome using quality-adjusted life years (QALYs) lost or disabilityadjusted life years (DALYs) gained, as Standaert [1] suggested in his comment, were not considered in this study. A CEA considering, all above, inputs and outcomes would be a next step in the series of analyses required to support potential vaccines' introductions.…”

“…Standaert [1] also commented on data usage by Postma et al [2], which we believe is merely a choice concerning the use of specific data and rendering corresponding results. Regarding the cost of hospitalization in geriatric vs. pulmonary care facilities, the data presented by Postma et al are based on the Technical Cell for the Management of Hospital Data (TCT) [9] database of Belgium, which includes the costs of both geriatric and pulmonology wards.…”

“…Presenting discounted results could be considered to support the next analytic steps toward CEAs. Regarding the concern of Standaert [1] about how deaths are accounted for in the model, we want to highlight that the projected RSV-related deaths are different between the vaccine and non-vaccine arms as a consequence of RSV cases averted by vaccination. The separate branch of overall mortality depicted in Figure 1 in the original manuscript [2] was to illustrate that in every model cycle, patients are first subject to overall mortality before accounting for RSV-related deaths with or without the vaccine's protection.…”