Predicting the long-term impact of rotavirus vaccination in 112 countries from 2006 to 2034: A transmission modeling analysis

• Type of Material: Article
• Authors: ANM Kraay, Emory University; MK Steele, Emory University; JM Baker, Emory University; EW Hall, Emory University; A Deshpande, Emory University; BF Saidzosa, Ministry of Health and Social Protection of Population of the Republic of Tajikistan; A Mukaratirwa, Ministry of Health and Child Welfare, Zimbabwe; A Boula, Mother & Child Hospital (MCH), Chantal Biya Foundation; EM Mpabalwani, University Teaching Hospital, Lusaka; NM Kiulia, Institute of Primate Research, Karen; E Tsolenyanu, Ministry of Health, Togo; C Enweronu-Laryeaj, University of Ghana; A Abebe, Ethiopian Public Health Institute, Addis Ababa; B Beyene, Ethiopian Public Health Institute, Addis Ababa; M Tefera, Ethiopian Public Health Institute, Addis Ababa; R Willilo, RTI International, Dar es Salaam; N Batmunkh, World Health Organization, Manila; R Pastore, World Health Organization Regional Office for the Europe, Copenhagen; JM Mwenda, WHO Regional Office for Africa; S Antoni, World Health Organization, Geneva; AL Cohen, World Health Organization, Geneva; VE Pitzer, Yale University; BA Lopman, Emory University
• Language: English
• Date: 2022-10-22
• Publisher: ELSEVIER SCI LTD
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2024 Elsevier B.V.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.vaccine.2022.09.072
• Title of Journal or Parent Work: VACCINE
• Volume: 40
• Issue: 46
• Start Page: 6631
• End Page: 6639
• Grant/Funding Information: This work was funded by the Vaccine Impact Modeling Consortium and the U.S. NIH/National Institute of Allergy and Infectious Diseases [grant number R01AI112970]. The funding sources had no role in the study design, collection and interpretation of data, in the writing of the report, or in the decision to submit this work for publication.
• Keywords: Research & Experimental Medicine; SAFETY; Life Sciences & Biomedicine; INFECTION; MORTALITY; HERD-IMMUNITY; PATHOGENS; Medicine, Research & Experimental; Rotavirus; MIDDLE-INCOME COUNTRIES; Partial dose; Indirect effects; Rotateq; Direct effects; Immunology; Science & Technology; Rotarix
• Research Categories: Mathematics; Health Sciences, Public Health; Health Sciences, Epidemiology

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.