COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA

Intro: Two rotavirus vaccines are licensed in China (RotaTeq and Lanzhou Lamb Rotavirus [LLR] vaccine), but their use is not widespread. We sought to understand the public health impact of widespread rotavirus vaccination with these two vaccines on public health outcomes, in China, among children ag...

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Main Authors: S. Oluwaseun, C. Yang, S.J. Si Tu, Y. Song, F. Han, C. Gu, J. Signorovitch, X.C. Wang, R. Bian, C. Carias
Format: Article
Language:English
Published: Elsevier 2023-05-01
Series:International Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S120197122300454X
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author S. Oluwaseun
C. Yang
S.J. Si Tu
Y. Song
F. Han
C. Gu
J. Signorovitch
X.C. Wang
R. Bian
C. Carias
author_facet S. Oluwaseun
C. Yang
S.J. Si Tu
Y. Song
F. Han
C. Gu
J. Signorovitch
X.C. Wang
R. Bian
C. Carias
author_sort S. Oluwaseun
collection DOAJ
description Intro: Two rotavirus vaccines are licensed in China (RotaTeq and Lanzhou Lamb Rotavirus [LLR] vaccine), but their use is not widespread. We sought to understand the public health impact of widespread rotavirus vaccination with these two vaccines on public health outcomes, in China, among children ages 0- 7 years old. Methods: We developed a Markov Model to simulate a birth cohort from 0 to 7 years of age under three scenarios- i) vaccination with RotaTeq; ii) vaccination with LLR; iii) no-vaccination; and calculated each scenario's expected number of health outcomes. The model was parameterized using published information on rotavirus epidemiology, RotaTeq and LLR effectiveness in China, as abstracted from national estimates and peer-reviewed literature. We assumed individuals could have up to five rotavirus infections, the first two being the ones that could lead to hospitalization. We considered high (90%) and low (50%) vaccination coverage scenarios (since rotavirus vaccines are not reimbursed) and fitted the model by changing the percent of immunity conferred by previous infection and the asymptomatic to symptomatic ratio. Findings: For a cohort of 100,000 children over the first 7 years of life, and in the absence of a rotavirus vaccine in China, 899 hospitalizations, 11,708 outpatient visits, and 64,746 symptomatic rotavirus cases are expected. Using RotaTeq, 67% (39%) of hospitalizations, and 61% (35%) of outpatient visits and rotavirus cases can be averted under the high (low) vaccination coverage scenario. Given lower vaccine effectiveness estimates for LLR, its use would avert 24% (14%) hospitalizations, 24% (14%) outpatient visits, and 24% (14%) rotavirus symptomatic cases compared to no vaccination, in the high (low) vaccination coverage scenario. Conclusion: Widespread use of rotavirus vaccination can avert a significant number of rotavirus gastroenteritis outcomes, with a three to two times higher potential public health impact for RotaTeq compared to LLR.
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spelling doaj.art-81da9d2f895140309e446e679fc97f1c2023-05-18T04:39:02ZengElsevierInternational Journal of Infectious Diseases1201-97122023-05-01130S131S132COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINAS. Oluwaseun0C. Yang1S.J. Si Tu2Y. Song3F. Han4C. Gu5J. Signorovitch6X.C. Wang7R. Bian8C. Carias9Merck, BARDS-HEDS, North Wales, PA, United States of AmericaAnalysis Group, Health Economics & Outcomes Research, Beijing, ChinaMSD, Outcomes Research, Beijing, ChinaAnalysis Group, Health Economics & Outcomes Research, Boston, MA, United States of AmericaAnalysis Group, Health Economics & Outcomes Research, Beijing, ChinaAnalysis Group, Health Economics & Outcomes Research, Beijing, ChinaAnalysis Group, Health Economics & Outcomes Research, Boston, MA, United States of AmericaMSD, Outcomes Research, Beijing, ChinaMSD, Medical Affairs, Beijing, ChinaMerck, CORE, North Wales, PA, United States of AmericaIntro: Two rotavirus vaccines are licensed in China (RotaTeq and Lanzhou Lamb Rotavirus [LLR] vaccine), but their use is not widespread. We sought to understand the public health impact of widespread rotavirus vaccination with these two vaccines on public health outcomes, in China, among children ages 0- 7 years old. Methods: We developed a Markov Model to simulate a birth cohort from 0 to 7 years of age under three scenarios- i) vaccination with RotaTeq; ii) vaccination with LLR; iii) no-vaccination; and calculated each scenario's expected number of health outcomes. The model was parameterized using published information on rotavirus epidemiology, RotaTeq and LLR effectiveness in China, as abstracted from national estimates and peer-reviewed literature. We assumed individuals could have up to five rotavirus infections, the first two being the ones that could lead to hospitalization. We considered high (90%) and low (50%) vaccination coverage scenarios (since rotavirus vaccines are not reimbursed) and fitted the model by changing the percent of immunity conferred by previous infection and the asymptomatic to symptomatic ratio. Findings: For a cohort of 100,000 children over the first 7 years of life, and in the absence of a rotavirus vaccine in China, 899 hospitalizations, 11,708 outpatient visits, and 64,746 symptomatic rotavirus cases are expected. Using RotaTeq, 67% (39%) of hospitalizations, and 61% (35%) of outpatient visits and rotavirus cases can be averted under the high (low) vaccination coverage scenario. Given lower vaccine effectiveness estimates for LLR, its use would avert 24% (14%) hospitalizations, 24% (14%) outpatient visits, and 24% (14%) rotavirus symptomatic cases compared to no vaccination, in the high (low) vaccination coverage scenario. Conclusion: Widespread use of rotavirus vaccination can avert a significant number of rotavirus gastroenteritis outcomes, with a three to two times higher potential public health impact for RotaTeq compared to LLR.http://www.sciencedirect.com/science/article/pii/S120197122300454X
spellingShingle S. Oluwaseun
C. Yang
S.J. Si Tu
Y. Song
F. Han
C. Gu
J. Signorovitch
X.C. Wang
R. Bian
C. Carias
COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA
International Journal of Infectious Diseases
title COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA
title_full COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA
title_fullStr COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA
title_full_unstemmed COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA
title_short COMPARATIVE PUBLIC HEALTH IMPACT OF ROTAVIRUS VACCINATION IN CHINA
title_sort comparative public health impact of rotavirus vaccination in china
url http://www.sciencedirect.com/science/article/pii/S120197122300454X
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