Assessment found that immunisation is safe and effective, but over five years would cost up to €60 million for babies and €70 for older adults.
Offering RSV vaccination to infants and older adults would only be cost effective if the HSE can negotiate much lower prices for the vaccines than those currently listed, the health regulator has said.
In its assessment of immunisation against respiratory syncytial virus (RSV), the Health Information and Quality Authority (HIQA) said that the vaccine is safe and effective in significantly reducing hospitalisations in winter and saving lives.
However, it found that, under current prices, introducing a national vaccination programme for babies and older adults would not be value for money under current pay thresholds.
Under listed prices for the vaccine, HIQA estimates that immunisation for all infants would cost the HSE €50 to €60 million over five years, while providing the inoculation to adults aged 80 and older would cost €70 million over the same timeframe.
“RSV immunisation significantly reduces hospitalisation with the greatest benefit in infants due to the highest burden of disease in this patient group,” said HIQA deputy director Dr Máirín Ryan.
“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 said that RSV results in approximately 1,800 hospital discharges and 130 ICU stays in children aged less than two years each year.
Approximately nine 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 one in every two of these discharges are in those aged 80 years and older.
During the last two winter seasons infants have been able to receive protection from RSV infection through a pilot immunisation programme.
An evaluation of the RSV Immunisation Pathfinder Programme for Winter 2024/25 estimated that the initiative averted 1,030 laboratory-confirmed cases of RSV infection in infants.
A total of 440 non-hospitalised ED presentations, 433 hospitalisations, and 79 ICU admissions were averted as a result of the programme, which provided free immunisation to infants born between September 1, 2024 and February 28, 2025.
GPs described the programme as a ‘game changer’ but raised concerns that a lack of resources and awareness among parents are impacting on its success.
“All stakeholder groups welcomed the initiative, stating that ‘it’s a good measure to protect babies’, and staff were ‘proud to promote it’,” said the report which was written by specialist registrar in public health medicine Dr Michael Hanrahan.
“Paediatricians and General Practitioners (GPs) described the RSV immunisation as ‘a game changer’. They noted that they saw fewer children present with RSV-related symptoms, and those that did have RSV and were immunised were ‘turning around quicker and needing less support’.”
HIQA’s health technology assessment 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.
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