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Peer-reviewedCC BYJMIR research protocols

Efficacy, Effectiveness, and Immunogenicity of the Respiratory Syncytial Virus Prefusion F Vaccine Administered During Pregnancy: Protocol for a Living Systematic Review and Meta-Analysis.

8 more authors
7 affiliations
  1. 1Institute for Clinical Effectiveness and Health Policy (IECS), Lavalleja 856, Buenos Aires, C1414DTR, Argentina, 54 0111558570687.
  2. 2Medical Evidence Development, Research & Development, Pfizer, Inc., New York, NY, United States.
  3. 3Maternal Immunization Team, Global Medical Affairs, Pfizer (United States), New York, NY, United States.
  4. 4Statistical Research and Data Science Center, Data Sciences and Analytics, Pfizer, Inc., New York, NY, United States.
  5. 5Department of Epidemiology, Celia Scott Weatherhead School of Public Health, Tulane University, New Orleans, LA, United States.
  6. 6Departments of Pharmacy and Global Health, University of Washington, Seattle, WA, United States.
  7. 7Departments of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, United States.

Abstract

Background

Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease in infants, with the highest burden in the first 6 months of life. Maternal immunization with the bivalent (RSV-A and RSV-B) prefusion F (RSVPreF) protein subunit vaccine (ABRYSVO) is a recently recommended strategy for preventing RSV-related outcomes in infants. First licensed for use in pregnancy in 2023, the RSVPreF vaccine demonstrated efficacy in a single pivotal randomized trial (Maternal Immunization Study for Safety and Efficacy; MATISSE); postlicensure real-world evidence on vaccine effectiveness across settings, seasons, and subgroups and on antibody durability and transplacental transfer remains limited and has not been synthesized in a continuously updated framework, motivating this review.Objective

This living systematic review and meta-analysis will synthesize emerging postlicensure data on the efficacy, effectiveness, and immunogenicity of the RSVPreF vaccine in real-world settings.Methods

We will conduct, in real time, a living systematic review and meta-analysis following Cochrane methods and PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidance, including randomized clinical trials and postlicensure real-world studies (eg, cohort, case-control, test-negative, and quasi-experimental studies). Primary objectives are evaluation of vaccine efficacy and effectiveness in preventing RSV-specific and all-cause respiratory disease and immunogenicity in infants and pregnant individuals. Vaccine effectiveness outcomes include RSV laboratory-confirmed infection, RSV acute respiratory illness, RSV lower respiratory tract disease, RSV hospitalization, RSV complications, all-cause lower respiratory tract disease and hospitalization, and antibiotic use in infants with RSV infection. Immunogenicity outcomes include maternal neutralizing antibody titers, maternal-infant transfer ratios, infant titers over time, and RSV viral load. We will search MEDLINE, Embase, the Cochrane Library, LILACS, Science Citation Index Expanded, Chinese biomedical and citation databases, clinical trial registries from January 2023 onward with no language restrictions, updating at least monthly. Two investigators will independently select studies, extract data, and assess risk of bias. Adjusted estimates will be standardized to vaccine efficacy and effectiveness. Certainty will be graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.Results

This living systematic review was funded in June 2025. Searches began in January 2023 and will continue with surveillance updates at least monthly until April 2028. As of January 2026, 837 records were screened, 105 (12.5%) were assessed in full text, and 12 (1.4%) met the inclusion criteria, of which 10 (1.2%) contributed extractable data. Data collection and analysis are ongoing and displayed on an interactive dashboard. Findings will be disseminated through peer-reviewed publications, conferences, and a real-time dashboard, with the first effectiveness estimates available in July 2026.Conclusions

This living systematic review and meta-analysis will provide a continuously updated synthesis of real-world evidence on maternal RSVPreF vaccination to inform clinical and policy decisions.

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BibTeX
@article{mazzoni2026efficacy,
  title = {{Efficacy, Effectiveness, and Immunogenicity of the Respiratory Syncytial Virus Prefusion F Vaccine Administered During Pregnancy: Protocol for a Living Systematic Review and Meta-Analysis.}},
  author = {Agustina Mazzoni and Ariel Bardach and Mabel Berrueta and Agustin Ciapponi and Karen Klein and Martin Brizuela and Carolina Nigri and Noelia Castellana and Jamile Ballivian and Juan Manuel Sambade and Katharina Stegelmann and Divya Patel and Jessica E Atwell and Jennifer Deese and Sarah N Cox and Lu Wang and Xu Xiong and Andy Stergachis and Flor M Munoz and Pierre Buekens},
  journal = {JMIR research protocols},
  year = {2026},
  month = oct,
  doi = {10.2196/94382},
  url = {https://europepmc.org/article/MED/42893392},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Efficacy, Effectiveness, and Immunogenicity of the Respiratory Syncytial Virus Prefusion F Vaccine Administered During Pregnancy: Protocol for a Living Systematic Review and Meta-Analysis.
AU  - Agustina Mazzoni
AU  - Ariel Bardach
AU  - Mabel Berrueta
AU  - Agustin Ciapponi
AU  - Karen Klein
AU  - Martin Brizuela
AU  - Carolina Nigri
AU  - Noelia Castellana
AU  - Jamile Ballivian
AU  - Juan Manuel Sambade
AU  - Katharina Stegelmann
AU  - Divya Patel
AU  - Jessica E Atwell
AU  - Jennifer Deese
AU  - Sarah N Cox
AU  - Lu Wang
AU  - Xu Xiong
AU  - Andy Stergachis
AU  - Flor M Munoz
AU  - Pierre Buekens
PY  - 2026
DA  - 2026/10/15
JO  - JMIR research protocols
DO  - 10.2196/94382
UR  - https://europepmc.org/article/MED/42893392
AB  - Background  Respiratory syncytial virus (RSV) is a leading cause of lower respiratory tract disease in infants, with the highest burden in the first 6 months of life. Maternal immunization with the bivalent (RSV-A and RSV-B) prefusion F (RSVPreF) protein subunit vaccine (ABRYSVO) is a recently recommended strategy for preventing RSV-related outcomes in infants. First licensed for use in pregnancy in 2023, the RSVPreF vaccine demonstrated efficacy in a single pivotal randomized trial (Maternal Immunization Study for Safety and Efficacy; MATISSE); postlicensure real-world evidence on vaccine effectiveness across settings, seasons, and subgroups and on antibody durability and transplacental transfer remains limited and has not been synthesized in a continuously updated framework, motivating this review.Objective  This living systematic review and meta-analysis will synthesize emerging postlicensure data on the efficacy, effectiveness, and immunogenicity of the RSVPreF vaccine in real-world settings.Methods  We will conduct, in real time, a living systematic review and meta-analysis following Cochrane methods and PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidance, including randomized clinical trials and postlicensure real-world studies (eg, cohort, case-control, test-negative, and quasi-experimental studies). Primary objectives are evaluation of vaccine efficacy and effectiveness in preventing RSV-specific and all-cause respiratory disease and immunogenicity in infants and pregnant individuals. Vaccine effectiveness outcomes include RSV laboratory-confirmed infection, RSV acute respiratory illness, RSV lower respiratory tract disease, RSV hospitalization, RSV complications, all-cause lower respiratory tract disease and hospitalization, and antibiotic use in infants with RSV infection. Immunogenicity outcomes include maternal neutralizing antibody titers, maternal-infant transfer ratios, infant titers over time, and RSV viral load. We will search MEDLINE, Embase, the Cochrane Library, LILACS, Science Citation Index Expanded, Chinese biomedical and citation databases, clinical trial registries from January 2023 onward with no language restrictions, updating at least monthly. Two investigators will independently select studies, extract data, and assess risk of bias. Adjusted estimates will be standardized to vaccine efficacy and effectiveness. Certainty will be graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.Results  This living systematic review was funded in June 2025. Searches began in January 2023 and will continue with surveillance updates at least monthly until April 2028. As of January 2026, 837 records were screened, 105 (12.5%) were assessed in full text, and 12 (1.4%) met the inclusion criteria, of which 10 (1.2%) contributed extractable data. Data collection and analysis are ongoing and displayed on an interactive dashboard. Findings will be disseminated through peer-reviewed publications, conferences, and a real-time dashboard, with the first effectiveness estimates available in July 2026.Conclusions  This living systematic review and meta-analysis will provide a continuously updated synthesis of real-world evidence on maternal RSVPreF vaccination to inform clinical and policy decisions.
SN  - 1929-0748
ER  -