Rotavirus vaccine administration patterns in Italy: potential impact on vaccine coverage, compliance and adherence. Issue 5 (4th May 2021)

• Record Type: Journal Article
• Authors: Martinelli, Domenico; Fortunato, Francesca; Marchetti, Federico; Prato, Rosa
• Is Part Of: Human vaccines & immunotherapeutics. Volume 17:Issue 5(2021)
• Page Start: 1546
• Page End: 1551
• Publication Date: 2021-05-04
• Subjects: Rotavirus -- vaccine -- Italy -- schedule -- administration -- compliance -- adherence -- gastro-enteritis -- children -- pediatric vaccination; Vaccines -- Periodicals; 615.372
• DOI: 10.1080/21645515.2020.1816109
• Languages: English
• ISSNs: 2164-5515

Abstract

ABSTRACT: Acceptance of rotavirus (RV) vaccination may be impacted by several factors including the feasibility of the full schedule administration within the fixed immunization timelines. The human RV vaccine Rotarix (GSK) and the human bovine reassortant vaccine RotaTeq (Merck & Co.) were developed with different posologies (2 doses vs 3 doses respectively), which have both scientific and technical implications. A non-systematic literature review revealed that, in the Italian context, topics such as time to achieve RV protection in children, number of preventable cases and administration time window, compatibility/ease of inclusion in the national vaccination calendar, potential overlaps with the peak of natural history of intussusception and adherence to posology could be impacted by the RV vaccine posology. Results suggest that a shorter schedule would allow for greater flexibility of use as well as a greater documented ease of inclusion in the vaccination calendar, thereby reducing potential direct healthcare costs. PLAIN LANGUAGE SUMMARY: What is the context? Rotavirus is a major cause of acute gastroenteritis across the world. In 2017, universal mass vaccination against rotavirus was introduced in Italy. The vaccine is offered free of charge for all new-borns. The human rotavirus vaccine (HRV; GSK) and the human bovine reassortant vaccine (HBRV; Merck & Co.) are the two available vaccines against rotavirus. They differ in the number of doses and timelines to be administered to achieve a full vaccination series (two for HRV and three for HBRV). Previous studies reported the difficulty in improving rotavirus vaccination coverage due to various causes, including misperception of the severity of the disease, fears about the safety of the vaccines and the fixed time ranges for starting and completing the full series. What is new? We conducted a literature review to look at the clinical and economic implications of the differences between both recommended dosing schedules. Our review suggests that a 2-dose schedule may allow: an easier inclusion in existing vaccination calendars a higher adherence to the recommended dosing schedule a higher vaccination coverage, as seen in other countries such as Mexico, the USA, Belgium and Italy. What is the impact? The posology of rotavirus vaccines results in a series of technical and scientific differences that may affect the time to achieve rotavirus protection in children. The higher coverage and earlier protection should result in fewer cases, and thereby decreased direct medical costs, and a reduced burden on families and the Italian National Health System.