Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries
Abstract Rotavirus is a leading cause of diarrhea deaths in children, particularly in low-to-middle income countries (LMICs). Licensed rotavirus vaccines provide strong direct protection, but their indirect effect—the protection due to reduced transmission—is not fully understood. We aimed to quanti...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-03-01
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| Series: | npj Vaccines |
| Online Access: | https://doi.org/10.1038/s41541-023-00632-y |
| _version_ | 1797426555971960832 |
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| author | A. N. M. Kraay D. M. Chaney A. Deshpande V. E. Pitzer B. A. Lopman |
| author_facet | A. N. M. Kraay D. M. Chaney A. Deshpande V. E. Pitzer B. A. Lopman |
| author_sort | A. N. M. Kraay |
| collection | DOAJ |
| description | Abstract Rotavirus is a leading cause of diarrhea deaths in children, particularly in low-to-middle income countries (LMICs). Licensed rotavirus vaccines provide strong direct protection, but their indirect effect—the protection due to reduced transmission—is not fully understood. We aimed to quantify the population-level effects of rotavirus vaccination and identify factors that drive indirect protection. We used an SIR-like transmission model to estimate the indirect effects of vaccination on rotavirus deaths in 112 LMICs. We performed a regression analysis to identify predictors of indirect effect magnitude (linear regression) and the occurrence of negative indirect effects (logistic regression). Indirect effects contributed to vaccine impacts in all regions, with effect sizes 8-years post-vaccine introduction ranging from 16.9% in the WHO European region to 1.0% in the Western Pacific region. Indirect effect estimates were higher in countries with higher under-5 mortality, higher vaccine coverage, and lower birth rates. Of the 112 countries analyzed, 18 (16%) had at least 1 year with a predicted negative indirect effect. Negative indirect effects were more common in countries with higher birth rate, lower under-5 mortality and lower vaccine coverage. Rotavirus vaccination may have a larger impact than would be expected from direct effects alone, but the impact of these indirect effects is expected to vary by country. |
| first_indexed | 2024-03-09T08:31:55Z |
| format | Article |
| id | doaj.art-8c74a2a365a74cbaaf905b4c92d476de |
| institution | Directory Open Access Journal |
| issn | 2059-0105 |
| language | English |
| last_indexed | 2024-03-09T08:31:55Z |
| publishDate | 2023-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Vaccines |
| spelling | doaj.art-8c74a2a365a74cbaaf905b4c92d476de2023-12-02T19:28:56ZengNature Portfolionpj Vaccines2059-01052023-03-01811810.1038/s41541-023-00632-yPredicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countriesA. N. M. Kraay0D. M. Chaney1A. Deshpande2V. E. Pitzer3B. A. Lopman4Department of Kinesiology and Community Health, University of Illinois at Urbana-ChampaignHubert Department of Global Health, Rollins School of Public Health, Emory UniversityDepartment of Epidemiology, Rollins School of Public Health, Emory UniversityDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale UniversityDepartment of Epidemiology, Rollins School of Public Health, Emory UniversityAbstract Rotavirus is a leading cause of diarrhea deaths in children, particularly in low-to-middle income countries (LMICs). Licensed rotavirus vaccines provide strong direct protection, but their indirect effect—the protection due to reduced transmission—is not fully understood. We aimed to quantify the population-level effects of rotavirus vaccination and identify factors that drive indirect protection. We used an SIR-like transmission model to estimate the indirect effects of vaccination on rotavirus deaths in 112 LMICs. We performed a regression analysis to identify predictors of indirect effect magnitude (linear regression) and the occurrence of negative indirect effects (logistic regression). Indirect effects contributed to vaccine impacts in all regions, with effect sizes 8-years post-vaccine introduction ranging from 16.9% in the WHO European region to 1.0% in the Western Pacific region. Indirect effect estimates were higher in countries with higher under-5 mortality, higher vaccine coverage, and lower birth rates. Of the 112 countries analyzed, 18 (16%) had at least 1 year with a predicted negative indirect effect. Negative indirect effects were more common in countries with higher birth rate, lower under-5 mortality and lower vaccine coverage. Rotavirus vaccination may have a larger impact than would be expected from direct effects alone, but the impact of these indirect effects is expected to vary by country.https://doi.org/10.1038/s41541-023-00632-y |
| spellingShingle | A. N. M. Kraay D. M. Chaney A. Deshpande V. E. Pitzer B. A. Lopman Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries npj Vaccines |
| title | Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries |
| title_full | Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries |
| title_fullStr | Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries |
| title_full_unstemmed | Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries |
| title_short | Predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries |
| title_sort | predicting indirect effects of rotavirus vaccination programs on rotavirus mortality among children in 112 countries |
| url | https://doi.org/10.1038/s41541-023-00632-y |
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