{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:46:26Z","timestamp":1785818786540,"version":"3.56.0"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Respiratory syncytial virus (RSV) causes significant morbidity and mortality among older adults and individuals with chronic conditions. This study conducted a cost\u2013benefit analysis (CBA) to evaluate the societal value of RSV vaccination with the adjuvanted RSV prefusion F protein (RSVPreF3) vaccine among older adults aged \u226560\u202fyears and high-risk adults aged 50\u201359\u202fyears in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An actuarial population projection model, combined with a full CBA framework adapted to the Japanese setting, was used to estimate costs and benefits of adjuvanted RSVPreF3 vaccination versus no vaccination over a 10-year time horizon. Deterministic sensitivity analyses were conducted to assess parameter uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our results indicate that a 5-year vaccination program among older adults, including those aged 50\u201359\u202fyears at higher risk for severe RSV disease and those aged \u226560\u202fyears, was associated with substantial economic benefits. Among older adults aged \u226560\u202fyears, the total return on investment (ROI) was 3.3 with or without deadweight loss (DWL), with vaccination projected to avert Japanese Yen (JPY) 35,501\u202fM in productive output loss, save JPY 1,178,403\u202fM in direct healthcare costs, and prevent JPY 10,699,729\u202fM in monetized quality-adjusted life-year (QALY) loss. For high-risk adults aged 50\u201359\u202fyears, the total ROI was 3.7 without DWL and 3.8 with DWL, with corresponding reductions of JPY 17,889\u202fM in productive output loss, JPY 10,400\u202fM in healthcare costs, and JPY 266,116\u202fM in monetized QALY loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Overall, adjuvanted RSVPreF3 vaccination among older adults in Japan represents good value for money from a societal perspective, where vaccine acquisition and administration costs are expected to be outweighed by substantial health, productivity, and broader economic benefits.<\/jats:p>\n                  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