Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis.
Currently, Indian officials are incorporating a domestically manufactured rotavirus vaccine (based on the 116E rotavirus strain) into the country's universal immunization program; this vaccine will cost significantly less than western rotavirus vaccines. Here, we examine the public health impac...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2017-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5669435?pdf=render |
| _version_ | 1818136486300614656 |
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| author | Johnie Rose Laura Homa Sharon B Meropol Sara M Debanne Roger Bielefeld Claudia Hoyen Mendel E Singer |
| author_facet | Johnie Rose Laura Homa Sharon B Meropol Sara M Debanne Roger Bielefeld Claudia Hoyen Mendel E Singer |
| author_sort | Johnie Rose |
| collection | DOAJ |
| description | Currently, Indian officials are incorporating a domestically manufactured rotavirus vaccine (based on the 116E rotavirus strain) into the country's universal immunization program; this vaccine will cost significantly less than western rotavirus vaccines. Here, we examine the public health impact, cost, and cost-effectiveness of universal vaccination in India using the 116E vaccine. This work will allow comparison of universal 116E vaccination with other approaches to child mortality reduction, shed light on the future burden of rotavirus disease in India, and help stakeholders understand future resource needs.Using information from published literature, we developed a dynamic simulation model of rotavirus transmission, natural history, and related utilization among Indian infants followed until age five. Infection risk depended on the degree of viral shedding in the population. Infection risk and severity were influenced by age, number of previous infections, and vaccination history. Probabilities of inpatient and outpatient health services utilization depended on symptom severity. With the model, we compared a strategy of nationwide 116E vaccination to one of no vaccination. Costs were considered from the perspective of all payers (including families) and from the societal perspective.We estimated that an established 116E vaccination program would reduce symptomatic rotavirus infection by 13.0%, while reducing population-wide rotavirus mortality by 34.6% (over 34,000 lives annually). Rotavirus outpatient visits would decline by 21.3%, and hospitalization would decline by 28.1%. The cost per disability-adjusted life year (DALY) averted was estimated at 3,429 Rupees (approximately $56). Predicted mortality reduction in children born during the first five years of vaccination implementation was nearly identical to that in children born in later years (34.4% versus 34.6%).116E vaccination of Indian infants would likely substantially reduce rotavirus-related morbidity, mortality, and utilization at a cost considered highly cost-effective by standard criteria. Nearly the entire mortality reduction benefit of vaccination was attributable to direct protection of those vaccinated, as opposed to indirect "herd immunity" effects. |
| first_indexed | 2024-12-11T09:41:10Z |
| format | Article |
| id | doaj.art-a07433b7d7da4a9083ff0007366f8033 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T09:41:10Z |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-a07433b7d7da4a9083ff0007366f80332022-12-22T01:12:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-011211e018744610.1371/journal.pone.0187446Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis.Johnie RoseLaura HomaSharon B MeropolSara M DebanneRoger BielefeldClaudia HoyenMendel E SingerCurrently, Indian officials are incorporating a domestically manufactured rotavirus vaccine (based on the 116E rotavirus strain) into the country's universal immunization program; this vaccine will cost significantly less than western rotavirus vaccines. Here, we examine the public health impact, cost, and cost-effectiveness of universal vaccination in India using the 116E vaccine. This work will allow comparison of universal 116E vaccination with other approaches to child mortality reduction, shed light on the future burden of rotavirus disease in India, and help stakeholders understand future resource needs.Using information from published literature, we developed a dynamic simulation model of rotavirus transmission, natural history, and related utilization among Indian infants followed until age five. Infection risk depended on the degree of viral shedding in the population. Infection risk and severity were influenced by age, number of previous infections, and vaccination history. Probabilities of inpatient and outpatient health services utilization depended on symptom severity. With the model, we compared a strategy of nationwide 116E vaccination to one of no vaccination. Costs were considered from the perspective of all payers (including families) and from the societal perspective.We estimated that an established 116E vaccination program would reduce symptomatic rotavirus infection by 13.0%, while reducing population-wide rotavirus mortality by 34.6% (over 34,000 lives annually). Rotavirus outpatient visits would decline by 21.3%, and hospitalization would decline by 28.1%. The cost per disability-adjusted life year (DALY) averted was estimated at 3,429 Rupees (approximately $56). Predicted mortality reduction in children born during the first five years of vaccination implementation was nearly identical to that in children born in later years (34.4% versus 34.6%).116E vaccination of Indian infants would likely substantially reduce rotavirus-related morbidity, mortality, and utilization at a cost considered highly cost-effective by standard criteria. Nearly the entire mortality reduction benefit of vaccination was attributable to direct protection of those vaccinated, as opposed to indirect "herd immunity" effects.http://europepmc.org/articles/PMC5669435?pdf=render |
| spellingShingle | Johnie Rose Laura Homa Sharon B Meropol Sara M Debanne Roger Bielefeld Claudia Hoyen Mendel E Singer Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis. PLoS ONE |
| title | Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis. |
| title_full | Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis. |
| title_fullStr | Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis. |
| title_full_unstemmed | Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis. |
| title_short | Health impact and cost-effectiveness of a domestically-produced rotavirus vaccine in India: A model based analysis. |
| title_sort | health impact and cost effectiveness of a domestically produced rotavirus vaccine in india a model based analysis |
| url | http://europepmc.org/articles/PMC5669435?pdf=render |
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