HIQA has today published a health technology assessment (HTA) of immunisation against respiratory syncytial virus (RSV) in Ireland. The HTA was requested by the Department of Health with the aim of informing long-term policy decisions by the Minister for Health regarding the immunisation of infants and older adults against RSV.

RSV is a common seasonal viral infection that affects the lungs and upper airways. RSV does not usually cause serious illness, but some groups, such as infants and older people, are at increased risk of severe illness. Every winter in Ireland, more than 7,000 people are diagnosed with RSV, with historically a large number of young children requiring admission to hospital, especially infants aged less than one year.

For the infant population, HIQA looked at immunising just those born during the RSV season or all babies during their first RSV season. It also considered different immunisation products, that is a maternal vaccine (administered to the mother) or a monoclonal antibody (administered to the baby). All RSV immunisation products considered were found to be safe and effective. HIQA found that all of the approaches would result in significant reductions in medically attended cases and RSV-related hospitalisations in infants. The estimated cost to the HSE over five years ranged from €15.6 million to provide the maternal vaccine to pregnant women whose baby will be born during RSV season, to €58.5 million for a strategy providing a monoclonal antibody to all babies during their first RSV season.

For the older adult population, RSV vaccination was also found to be safe and effective. However, the effectiveness of the vaccines, which are given as a once-off dose, wanes over time. The estimated cost of offering the vaccine to adults aged 80 years and older, the adult age group who are most at risk of RSV-related hospitalisation and death, was €70.6 million over five years. 

Commenting on the findings, HIQA’s Deputy CEO and Director of Health Technology Assessment, Dr Máirín Ryan, said:

“RSV results in a substantial burden of illness for vulnerable groups. It also creates a lot of challenges for our healthcare system, particularly in paediatric healthcare. RSV results in approximately 1,800 hospital discharges and 130 ICU stays in children aged less than two years each year. Approximately 9 in every 10 of these discharges are in children aged less than one year and occur mostly between October and December. In those aged 65 years and older, there are approximately 120 discharges each year with a primary diagnosis of RSV. Approximately 1 in every 2 of these discharges are in those aged 80 years and older. These seasonal RSV surges can lead to scheduled care being delayed, increase pressure on staff and undermine the resilience of the healthcare system.” 

Dr Ryan continued:

“RSV immunisation significantly reduces hospitalisation with the greatest benefit in infants due to the highest burden of disease in this patient group. While it would reduce winter overcrowding and help make our health service more resilient, it is very expensive. Our healthcare budget is finite, and cost effectiveness is an important part of any healthcare decision.”

HIQA’s HTA noted that longer-term effectiveness and safety data are likely to become available in the near future, which may influence the cost effectiveness of RSV immunisation. 

ENDS

Further information:

Caoimhe O’Connell, Communications Manager
caoconnell@hiqa.ie 

Notes for Editor: 

• HIQA has today published the following document:
  • Health technology assessment of immunisation against respiratory syncytial virus (RSV) in Ireland
  • Report on the results of the public consultation on the health technology assessment on immunisation against RSV in Ireland: Statement of outcomes
• For the 2024/25 RSV season, the HSE ran a pilot RSV immunisation programme, which offered RSV immunisation with the monoclonal antibody, nirsevimab to babies born between 1 September 2024 and 28 February 2025. Information on the impact of this programme can be found here. The HSE ran a second pilot programme for the 2025/26 RSV season, which included also a catch-up programme for infants aged less than six months on the 1 September 2025. The results of the HIQA analyses broadly aligned with the positive findings reported by the HSE for the 2024/25 pilot programme.
• There is considerable uncertainty around the likely cost of RSV immunisation products to the HSE. There may also be potential for price reductions through competitive tender.
  • At assumed prices of €301 and €165 (ex VAT) for a monoclonal antibody and maternal vaccine, respectively, the estimated five-year incremental budget impact ranged from €15.6 million for a strategy based on seasonal maternal vaccination to €58.5 million for a strategy offering a monoclonal antibody to all infants during their first RSV season. HIQA found that offering a monoclonal antibody to all infants in their first RSV season would be cost effective at a price of €166 (ex VAT) or less for the monoclonal antibody and a price of at least €90 for the maternal vaccine.
  • At currently available list prices of €165 (ex VAT) for the adult vaccine, the estimated five-year incremental budget impact for the strategies modelled ranged from €70.6 million to €73.7 million. HIQA found that offering the RSV vaccine to those aged 80 years and older in year one of the programme and to those turning 80 years in subsequent years would only be cost effective if the cost of the vaccine is reduced to €20.
• HIQA found that 22 European countries have recently introduced RSV immunisation programmes for infants, with eight countries introducing programmes for some groups of older adults. The programmes differ in terms of the subgroups to whom immunisation is offered, with some countries, like Ireland, implementing their programmes on a temporary basis.
   

About HIQA

The Health Information and Quality Authority (HIQA) is the independent body that promotes safety and quality in the provision of health and social care services in Ireland. 

Through its regulation, standard setting and evidence to inform decision-making functions, HIQA supports health and social care services to consistently deliver excellent standards of care and the best possible health and social care outcomes for all.