- Population-level impact: RSV prevention products were associated with a 43% relative reduction in hospitalizations and ED visits among infants ≤7 months in the second season, beyond trends in older children.
- No first-year effect: The first season (2023–2024) showed no statistically significant reduction (ratio of relative rates, 0.92), likely reflecting limited uptake (~39% coverage).
- Shift in disease burden: Median age of RSV cases increased from 9 to 12 months, suggesting reduced disease among the youngest infants.
- Heterogeneous and unequal impact: Reductions varied by county (15.5%–57.7%) and were smaller among Native Hawaiian or Other Pacific Islander children, who had the highest disease rates.
- Observational limitations: Findings are based on diagnosis codes without laboratory confirmation and an ecological design without individual-level exposure data, limiting causal inference.
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