Evidence map›Paper›PMID 30196794›Full record

ArticleBMC medicine2018

Updated cost-effectiveness and risk-benefit analysis of two infant rotavirus vaccination strategies in a high-income, low-endemic setting.

P Bruijning-Verhagen, J A P van Dongen, J D M Verberk, R Pijnacker, R D van Gaalen, D Klinkenberg, H E de Melker, M-J J Mangen

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.

  1. Pooled it
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  12. Accounting for indirect protection in the benefit-risk ratio estimation of rotavirus vaccination in children under the age of 5 years, France, 2018.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2020
    Article
  13. Review
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  15. Disease burden of varicella versus other vaccine-preventable diseases before introduction of vaccination into the national immunisation programme in the Netherlands.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2019
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

P Bruijning-VerhagenDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. p.bruijning@umcutrecht.nl.ORCID http://orcid.org/0000-0003-4105-9669
J A P van DongenJulius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
J D M VerberkDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
R PijnackerDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
R D van GaalenDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
D KlinkenbergDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
H E de MelkerDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
M-J J MangenDepartment of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
National Institute for Public Health and the Environment · NLUniversity Medical Center Utrecht · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveSince 2013, a biennial rotavirus pattern has emerged in the Netherlands with alternating high and low endemic years and a nearly 50% reduction in rotavirus hospitalization rates overall, while infant rotavirus vaccination has remained below 1% throughout. As the rotavirus vaccination cost-effectiveness and risk-benefit ratio in high-income settings is highly influenced by the total rotavirus disease burden, we re-evaluated two infant vaccination strategies, taking into account this recent change in rotavirus epidemiology.

methodsWe used updated rotavirus disease burden estimates derived from (active) surveillance to evaluate (1) a targeted strategy with selective vaccination of infants with medical risk conditions (prematurity, low birth weight, or congenital conditions) and (2) universal vaccination including all infants. In addition, we added herd protection as well as vaccine-induced intussusception risk to our previous cost-effectiveness model. An age- and risk-group structured, discrete-time event, stochastic multi-cohort model of the Dutch pediatric population was used to estimate the costs and effects of each vaccination strategy.

resultsThe targeted vaccination was cost-saving under all scenarios tested from both the healthcare payer and societal perspective at rotavirus vaccine market prices (€135/child). The cost-effectiveness ratio for universal vaccination was €51,277 at the assumed vaccine price of €75/child, using a societal perspective and 3% discount rates. Universal vaccination became cost-neutral at €32/child. At an assumed vaccine-induced intussusception rate of 1/50,000, an estimated 1707 hospitalizations and 21 fatal rotavirus cases were averted by targeted vaccination per vaccine-induced intussusception case. Applying universal vaccination, an additional 571 hospitalizations and <  1 additional rotavirus death were averted in healthy children per vaccine-induced intussusception case.

conclusionWhile universal infant rotavirus vaccination results in the highest reductions in the population burden of rotavirus, targeted vaccination should be considered as a cost-saving alternative with a favorable risk-benefit ratio for high-income settings where universal implementation is unfeasible because of budget restrictions, low rotavirus endemicity, and/or public acceptance.

Indexed as

ChildChild, PreschoolCost-Benefit AnalysisFemaleHumansInfantInfant, NewbornMaleRisk AssessmentRotavirus InfectionsRotavirus VaccinesSocioeconomic FactorsRotavirus VaccinesCost-effectivenessEconomic evaluationEpidemiologyIntussusceptionPrematurityRisk-benefitRisk factorsRotavirus vaccination

Identifiers

PMID30196794
PMCPMC6130096
OpenAlexW2889930147

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

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.