Background: Respiratory syncytial virus produces a considerable clinical and economic burden among adults sixty years of age and older. Recently approved vaccines have expanded prevention opportunities in this population, making economic evaluation central to policy and implementation decisions. Health systems face growing pressure to optimize spending, which increases the relevance of cost-effectiveness analysis for guiding vaccination strategy. Objective: To assess the economic value and clinical implications of RSV vaccination in older adults, with emphasis on evidence from the United States. Methods: A systematic review of U.S. cost-effectiveness analyses was conducted. Extracted elements included incremental cost-effectiveness ratios, willingness-to-pay thresholds, model assumptions, and sensitivity analysis parameters. Results: Across economic models, RSV vaccination showed favorable cost-effectiveness from a societal perspective in the United States and comparable high-income settings.[1–8] Payer-only analyses in U.S. studies were less favorable.[2] Vaccine efficacy, duration of protection, and hospitalization costs were the most influential determinants.[1,3–8] Conclusion: RSV vaccination for adults aged sixty years and older provides strong economic value from a societal perspective and supports inclusion in public health strategies. Prioritizing high-risk adults and integrating real-world evidence further strengthens the justification for sustained vaccination programs.
