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Age-specific antibody profiles of respiratory syncytial virus after COVID-19 pandemic: a sero-epidemiological survey in Taizhou City, Eastern China

Bo Zheng,Qiang Wang,Kathy Leung,Hongbiao Liang,W. Shen,Mengting Cao,Suyi Zhang,Ye Wu,Haijiang Lin,Weibing Wang

Published 2025 in BMC Infectious Diseases

ABSTRACT

The generalizability of the current quantitative assessments of age-specific RSV antibody levels remains unclear in China. We aimed to comprehensively understand the RSV immune profile at the population level and identify related factors. We conducted a community-based cross-sectional sero-epidemiological study in Taizhou City, Eastern China, from June 2 to 30, 2024, and assessed RSV pre-F IgG antibody titres. We employed generalized linear models to identify factors linked to antibody titres and used a generalized additive model to determine RSV seropositivity risk. The serocatalytic model was further used to estimate the force of infection (FOI) based on age-specific seroprevalence data. Among 1303 individuals aged 16 months to 93 years, toddlers (younger than 2 years) had the lowest geometric mean titres (GMTs) of RSV pre-F IgG antibodies, which was 591.9 (95% confidence interval [CI], 106.5-3291.1). The GMTs increased annually by 2.038-fold (0.842–4.011), attaining a titre of 6133.9 (4639.3-8110.2) by the age of 4. The seroprevalence (using titre > 200 as the threshold) surged sharply with age, from 46.1% (42.2–50.2) at 1 year of age to 91.5% (88.9–93.8) at age 4, with an estimated FOI of 0.618 (0.547–0.697). Children residing in households with over four members correlated with a heightened risk of seropositivity within the first 4 postnatal year compared to those in households with four or fewer members (adjusted odds ratio, aOR: 1.954, 1.082–3.529). Age was significantly associated with GMTs in the elderly individuals (aged 65 and above), with an estimated annual increment of 0.019-fold (0.004–0.034). Elderly with underlying diseases demonstrated a 0.203-fold (0.036–0.341) reduction in GMTs compared to those without such conditions. An early age-dependent pattern in RSV serostatus is observed, and the seroprevalence increased with age. Low antibody titres in early-life period and immunity impairment in the elderly due to underlying diseases emphasize the need to protect younger children and the elderly, from RSV infections. Not applicable.

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