Predicting the long-term impact of rotavirus vaccination in 112 countries from 2006 to 2034: A transmission modeling analysis. Issue 46 (2nd November 2022)

• Record Type: Journal Article
• Authors: Kraay, A.N.M.; Steele, M.K.; Baker, J.M.; Hall, E.W.; Deshpande, A.; Saidzosa, B.F.; Mukaratirwa, A.; Boula, A.; Mpabalwani, E.M.; Kiulia, N.M.; Tsolenyanu, E; Enweronu-Laryea, C.; Abebe, A.; Beyene, B.; Tefera, M.; Willilo, R.; Batmunkh, N.; Pastore, R.; Mwenda, J.M.; Antoni, S.; Cohen, A.L.; Pitzer, V.E.; Lopman, B.A.
• Is Part Of: Vaccine. Volume 40:Issue 46(2022)
• Page Start: 6631
• Page End: 6639
• Publication Date: 2022-11-02
• Subjects: Rotavirus -- Rotarix -- Rotateq -- Indirect effects -- Direct effects -- Partial dose; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2022.09.072
• Languages: English
• ISSNs: 0264-410X

Abstract

Highlights: Rotavirus vaccination is expected to reduce rotavirus mortality by 49% globally. These benefits are present for countries at all income levels. Most impact is due to direct benefits, but indirect effects also enhance impact. To sustain this benefit, a complete vaccine series is needed. Abstract: Rotavirus vaccination has been shown to reduce rotavirus burden in many countries, but the long-term magnitude of vaccine impacts is unclear, particularly in low-income countries. We use a transmission model to estimate the long-term impact of rotavirus vaccination on deaths and disability adjusted life years (DALYs) from 2006 to 2034 for 112 low- and middle-income countries. We also explore the predicted effectiveness of a one- vs two- dose series and the relative contribution of direct vs indirect effects to overall impacts. To validate the model, we compare predicted percent reductions in severe rotavirus cases with the percent reduction in rotavirus positivity among gastroenteritis hospital admissions for 10 countries with pre- and post-vaccine introduction data. We estimate that vaccination would reduce deaths from rotavirus by 49.1 % (95 % UI: 46.6–54.3 %) by 2034 under realistic coverage scenarios, compared to a scenario without vaccination. Most of this benefit is due to direct benefit to vaccinated individuals (explaining 69–97 % of the overall impact), but indirect protection also appears to enhance impacts. We find that a one-dose schedule would only be about 57 % as effective as a two-dose schedule 12 years after vaccine introduction. Our model closely reproduced observed reductions in rotavirus positivity in the first few years after vaccine introduction in select countries. Rotavirus vaccination is likely to have a substantial impact on rotavirus gastroenteritis and its mortality burden. To sustain this benefit, the complete series of doses is needed.