ArticleBMC medicine2013
Targeted rotavirus vaccination of high-risk infants; a low cost and highly cost-effective alternative to universal vaccination.
Article in BMC medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Penta- and hexavalent vaccination of extremely and very-to-moderate preterm infants born at less than 34 weeks and/or under 1500 g: A systematic literature review.Human vaccines & immunotherapeutics · 2023Pooled it
- Systematic review of the economic value of diarrheal vaccines.Human vaccines & immunotherapeutics · 2014Pooled it
- Indirect Effects in Health Economic Models of Vaccines: Should We Include Them, and How Do We Model Them?Applied health economics and health policy · 2026Review
- Acute Gastroenteritis Disease Burden in Infants With Medical Risk Conditions in the Netherlands.The Pediatric infectious disease journal · 2021Article
- Article
- Rotavirus vaccination for all children or subgroups only? Comment of the European Academy of Paediatrics (EAP) and the European Society for Paediatric Infectious Diseases (ESPID) recommendation group for rotavirus vaccination.European journal of pediatrics · 2020Article
- Rotavirus Vaccination Coverage During a Rotavirus Outbreak Resulting in a Fatality at a Subacute Care Facility.Journal of the Pediatric Infectious Diseases Society · 2020Article
- Projected impact and cost-effectiveness of community-based versus targeted azithromycin administration strategies for reducing child mortality in sub-Saharan Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Impact assessment of the incorporation of the rotavirus vaccine in the province of San Luis - Argentina.Epidemiology and infection · 2019Article
- Systematic Review and Meta-Analysis of Cost-effectiveness of Rotavirus Vaccine in Low-Income and Lower-Middle-Income Countries.Open forum infectious diseases · 2019Article
- Updated cost-effectiveness and risk-benefit analysis of two infant rotavirus vaccination strategies in a high-income, low-endemic setting.BMC medicine · 2018Article
- Effect of Rotavirus Vaccination on Acute Diarrheal Hospitalizations Among Low and Very Low Birth Weight US Infants, 2001-2015.The Pediatric infectious disease journal · 2018Article
- Article
- Potential safety issues and other factors that may affect the introduction and uptake of rotavirus vaccines.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2016Article
- Reply letter and clarifications on behalf of La Rosa and colleagues to Sicilian Public Health Authorities.Human vaccines & immunotherapeutics · 2016Article
- A multifactorial regression analysis of the features of community-acquired rotavirus requiring hospitalization in Spain as represented in the Minimum Basic Data Set.Epidemiology and infection · 2016Article
- Pediatric complex chronic conditions classification system version 2: updated for ICD-10 and complex medical technology dependence and transplantation.BMC pediatrics · 2014Article
- Economics and financing of vaccines for diarrheal diseases.Human vaccines & immunotherapeutics · 2014Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe cost-effectiveness of universal rotavirus (RV) vaccination is controversial in developed countries. As a result, RV vaccination programs do not currently exist in most European countries. Hospitalization is the main driver of RV disease costs, and prematurity, low birth weight (LBW) and underlying medical conditions have been associated with RV hospitalization and complications. We investigated the cost-effectiveness of targeted RV vaccination of high-risk infants and universal RV vaccination versus no vaccination.
methodsDisease burden, mortality and healthcare costs of RV hospitalization for children with and without prematurity, LBW and congenital pathology were quantified in two hospital-based observational studies in the Netherlands. Cost-effectiveness analysis was based on an age-structured stochastic multi-cohort model of the Dutch population comparing universal RV vaccination and targeted vaccination of high-risk infants to no vaccination. The primary endpoint was the incremental cost-effectiveness ratio (ICER), with a threshold of €35,000/quality-adjusted life year (QALY) from the healthcare provider perspective. Sensitivity analyses included vaccine price and coverage, herd-immunity and QALY losses.
resultsA total of 936 children with RV infection were included. Prematurity, LBW and congenital pathology were associated with increased risks of RV hospitalization (relative risks (RR) ranging from 1.6 to 4.4), ICU admission (RR ranging from 4.2 to 7.9), prolonged hospital stay (1.5 to 3.0 excess days) and higher healthcare costs (€648 to €1,533 excess costs). Seven children succumbed due to RV complications, all belonging to the high-risk population. Targeted RV vaccination was highly cost-effective and potentially cost-saving from the healthcare provider perspective with ICERs below €20,000/QALY in all scenarios with total (undiscounted) annual healthcare costs between -€0.1 and €0.5 million/year. Results were most sensitive to mortality rates, but targeted vaccination remained highly cost-effective up to reductions of 90% compared to observed mortality. Universal RV vaccination was not considered cost-effective (mean ICER: €60,200/QALY) unless herd-immunity and caretaker QALY losses were included and vaccine prices were €60 at most (mean ICER: €21,309/QALY).
conclusionWe recommend targeted RV vaccination for high-risk infants in developed countries.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.