Mortality reduction benefits and intussusception risks of rotavirus vaccination in 135 low-income and middle-income countries: a modelling analysis of current and alternative schedules

Publication date: November 2019Source: The Lancet Global Health, Volume 7, Issue 11Author(s): Andrew Clark, Jacqueline Tate, Umesh Parashar, Mark Jit, Mateusz Hasso-Agopsowicz, Nicholas Henschke, Benjamin Lopman, Kevin Van Zandvoort, Clint Pecenka, Paul Fine, Colin SandersonSummaryBackgroundInfant rotavirus vaccines have led to substantial reductions in hospital admissions and deaths due to gastroenteritis, but some studies have reported an elevated risk of intussusception, a rare bowel disorder. This analysis aimed to provide evidence on the potential mortality reduction benefits and intussusception risks of current rotavirus vaccination schedules, and to explore whether alternative schedules could have advantages.MethodsAll 135 low-income and middle-income countries, defined by gross national income per capita of less than US$12 236 in the 2018 fiscal year, were included in the model. Mortality reduction benefits and intussusception risks of rotavirus vaccination were modelled by use of an Excel-based static cohort model with a finely disaggregated age structure. Numbers of rotavirus gastroenteritis deaths and intussusception deaths in each week of age were calculated for all infants born in the year 2015 between birth and age 5·0 years, with and without restrictions on age at administration. Benefit–risk ratios (rotavirus gastroenteritis deaths prevented per excess intussusception death) and other indicators were calculated for two vaccination schedules currently reco...
Source: The Lancet Global Health - Category: International Medicine & Public Health Source Type: research