Every winter, the Respiratory Syncytial Virus (RSV) fills hospital wards. Around 6,000 older adults are admitted with RSV infection in the Netherlands each year — a figure almost certainly conservative, given how rarely RSV diagnostics are applied routinely in clinical practice. Effective vaccines have been available since 2023. Yet programmatic vaccination for adults aged 60 and over has not been implemented. A new report by Health-Ecore quantifies what that delay has meant for hospital capacity, reduced health and unnecessary costs.
Over three RSV seasons — 2024–25, 2025–26, and 2026–27 — an estimated 11,177 hospital admissions were (or are expected to be) avoidable, of which approximately 840 required intensive care. That is roughly 3,700 ward beds and 280 ICU admissions per winter that vaccination could have freed. These are not hypothetical numbers: they reflect the expected consequence of choosing to wait.
Averted monetary benefits by component
RSV admissions concentrate in December through February — exactly when intensive care and ward capacity are already under pressure from influenza and other respiratory infections. The system-level effect of 280 avoidable ICU admissions per season is therefore larger than the number implies: each freed bed has downstream consequences for surgical capacity, care quality, and workforce pressure across the hospital. This component of the burden is not captured in the monetised analysis, and its omission makes the reported benefits conservative.
The financial picture is equally clear. Total missed monetary benefits over three seasons amount to €635M (95% CI: €475M–€832M), against estimated programme costs of €293M, yielding net benefits of €341M. Avoided hospitalisation costs — €94M of the €99M in direct medical savings — are the dominant driver on the cost side, underscoring that it is the hospital burden, above all, that makes the economic case.
Societal cost-benefits
| Savings in the medical system | €99M |
| Productivity gains | €33M |
| QALY gains (valued at €50k/QALY) | €502M |
| Subtotal benefits | €634M |
| Vaccination costs* | €241M |
| Administration costs | €52M |
| Subtotal costs | €293M |
| Net benefits | €341M |
*: assuming a per dose acquisition cost of €75, which is a sizeable discount from the list price. QALY: Quality-Adjusted Life Year
Beyond hospital admissions, an estimated 3,219 deaths and 69,205 GP visits were also avoidable over the three seasons. The analysis also shows 10,054 QALYs lost, valued at €503M at a threshold of €50,000 per QALY.
The Dutch Health Council (Gezondheidsraad) concluded in March 2025 that RSV vaccination for older adults is warranted and recommended a programme for adults aged 75 and over and for high-risk groups from age 60. Uncertainty about protection duration has so far prevented a definitive implementation decision. However, each additional season without a programme adds to the hospital burden described here. The economic case is robust across a wide range of assumptions: even at a willingness-to-pay threshold of €20,000 per QALY, net benefits remain positive at €40M.
This project was funded by GSK, Moderna, and Pfizer, all producers of RSV vaccines.