RSV vaccination: a cost-effective strategy for older adults in the Netherlands

Respiratory Syncytial Virus (RSV) is increasingly recognized as a serious health threat for older adults. In the Netherlands, RSV may lead to thousands of GP visits and hospitalizations annually among adults aged 60 and older, but the extent of this burden remains uncertain and is probably underreported. 

In March 2025, the Dutch Health Council recommended offering RSV vaccination to adults aged 75 and older, as well as those aged 60–74 living in long-term care or with medical risk conditions. While the vaccines are considered safe and effective, questions remain about the duration of protection and the potential need for booster doses.

To support policy decisions, Health-Ecore developed an independent cost-effectiveness model evaluating various vaccination strategies in the Netherlands. The model integrates real-world effectiveness data on hospitalization with meta-analysis-based efficacy estimates for outpatient and non-medically attended cases. It assesses multiple strategies, including triennial and biennial vaccination intervals, across different older age groups.

Key Findings 

The results show that triennial vaccination of adults aged ≥75 and high-risk individuals aged 60–74 could have a significant public health and economic impact. In the first year alone, this strategy could prevent: 

• 19,000 GP visits 

• 3,300 hospitalizations, including 245 ICU admissions 

• 870 deaths 

• Save €29.5 million in healthcare costs and €6.3 million in productivity losses 

• Gain 2,900 quality-adjusted life years (QALYs) 

This strategy is cost-effective, with an average cost-effectiveness ratio (ACER) of €30,804 per QALY gained 

Among all strategies evaluated, vaccinating adults aged ≥75 every three years was the most cost-effective, with an incremental cost-effectiveness ratio (ICER) of €23,080 per QALY compared to no vaccination. While vaccinating all adults aged ≥60 resulted in the highest QALY gain, it came at a higher cost (ICER: €107,623 per QALY compared to the ≥75 and high-risk strategy). Biennial strategies were less favorable and dominated in incremental comparisons. 

Want to gain more insights?

Read the full article or explore the model results in the interactive online model, built using R.

This research is based on an open and independent model that evaluates a generic RSV vaccine to support national decision-making.

The study was conducted in collaboration with Moderna and Pfizer.