Author ORCID Identifier

https://orcid.org/0009-0005-1212-8858

Date of Award

Spring 4-22-2024

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Prof. Ike Solomon Okosun

Second Advisor

Dr. Alexander Kirpich

Abstract

Introduction: Globally, respiratory syncytial virus (RSV) causes a significant amount of disease and mortality in all ages, with the greatest impact on preterm babies. Maternal immunization during pregnancy has been identified as a possible strategy for preventing RSV-associated lower respiratory tract infections (LRTI) and RSV-associated hospitalizations in babies.

Aim: We aimed to synthesize randomized controlled trials data and provide a current update and overview of the efficacy and safety of all available maternal RSV vaccines.

Methods: We searched six databases-PubMed, Embase, Cochrane Library, Web of Science, Google scholar, and ClinicalTrials.gov until January 15, 2024, for all randomized controlled trials (RCTs) that compared maternal or infants’ vaccination against any placebo or a comparator. The meta-analysis was carried out using RevMan Web software and include six eligible RCTs with a focus on evaluating maternal RSV vaccine safety and efficacy in mothers and their infants.

Results: The analysis included six RCTs on maternal RSV vaccines (n = 12,652 mothers & n = 12,356 infants). The overall risk of bias and certainty of evidence was low. The findings revealed significant risk reduction in MA LRTI (RR: 0.50, 95% CI: 0.35, 0.71, p < 0.0001) and RSV-related hospitalizations (RR: 0.37, 95% CI: 0.18, 0.74, p = 0.005) in the first 6 months of life. Safety results showed significant different in the incidence of adverse events between the two groups (RR: 1.08, 95% CI: 1.04, 1.12, p < 0.0001). Vaccinated groups were more likely than placebo group to report injection site pain, swelling, and erythema. There was no significant difference in serious adverse events in infants (RR: 0.98, 95% CI: 0.93, 1.04, p = 0.52) and maternal participants (RR: 1.05, 95% CI: 0.97, 1.15, p = 0.23), and in adverse events in infants (RR: 1.03, 95% CI: 0.95, 1.12, p = 0.48).

Conclusion: Maternal RSV vaccination is a safe and effective approach in preventing RSV-associated LRTI and RSV-associated hospitalization in infants.

DOI

https://doi.org/10.57709/36982718

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