Abstract
Rotavirus (RV) is the main cause of acute gastroenteritis (AGE) in young children. The San Luis province of Argentina introduced RV vaccination in May 2013. We estimate vaccine impact (RVI) using real-world data. Data on all-cause AGE cases and AGE-related hospitalisations for San Luis and the adjacent Mendoza province (control group) were obtained and analysed by interrupted time-series methods. Regardless of the model used for counterfactual predictions, we estimated a reduction in the number of all-cause AGE cases of 20-25% and a reduction in AGE-related hospitalisations of 55-60%. The vaccine impact was similar for each age group considered (<1 year, <2 years and <5 years). RV vaccination was estimated to have reduced direct medical costs in the province by about 4.5 million pesos from May 2013 to December 2014. Similar to previous studies, we found a higher impact of RV vaccination in preventing severe all-cause AGE cases requiring hospitalisation than in preventing all-cases AGE cases presenting for medical care. An assessment of the economic value of RV vaccination could take other benefits into account in addition to the avoided medical costs and the costs of vaccination.
Highlights
Rotavirus (RV) infection is the main cause of severe diarrhea and acute gastroenteritis (AGE) in infants and young children, while diarrhea is the second most frequent cause of childhood death [1]
Time-trend analysis for AGE cases in San Luis (2008–2016) The results summarised in the upper part of Table 1 indicate a statistically significant relative reduction of 19%
Time-trend analysis of AGE cases in San Luis adjusting with Mendoza data as control (2008–2014) These results summarised in the lower part of Table 1 show a statistically significant relative reduction of 20% of all-cause AGE cases in children younger than 5 years with similar relative reductions for the two youngest groups
Summary
Rotavirus (RV) infection is the main cause of severe diarrhea and acute gastroenteritis (AGE) in infants and young children, while diarrhea is the second most frequent cause of childhood death [1]. Virtually all children will have been infected with RV before the age of 5 years and suffered an RV gastroenteritis (RVGE) with diarrhea, vomiting and other symptoms like nausea and stomach cramps. Some countries in the continent, Chile, Uruguay and Argentina among them, with very low-diarrhea-associated childhood mortality rates did not at first adopt RV vaccination widely. These countries allowed primary-care physicians to administer RV vaccination on an individual basis [5]. Contrary to Chile and Uruguay where population-wide RV vaccination has not yet been introduced, Argentina included this in its national routine childhood vaccination program in January 2015 [6]. Like all the vaccines in the program, RV vaccination is provided at zero out-of-pocket costs for all children
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