Evidence map›Paper›PMID 33891885›Full record

ArticleThe Lancet. Global health2021

Evaluating the potential economic and health impact of rotavirus vaccination in 63 middle-income countries not eligible for Gavi funding: a modelling study.

Frédéric Debellut, Andrew Clark, Clint Pecenka, Jacqueline Tate, Ranju Baral, Colin Sanderson, Umesh Parashar, Deborah Atherly

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

Article in The Lancet. Global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
1.5field-weighted citation impact, top 15% 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

21 citing papers in PubMed, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Frédéric DebellutCenter for Vaccine Innovation and Access, PATH, Geneva, Switzerland. Electronic address: fdebellut@path.org.
Andrew ClarkDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Clint PecenkaCenter for Vaccine Innovation and Access, PATH, Seattle, WA, USA.
Jacqueline TateDivision of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ranju BaralCenter for Vaccine Innovation and Access, PATH, Seattle, WA, USA.
Colin SandersonDepartment of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Umesh ParasharDivision of Viral Diseases, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Deborah AtherlyCenter for Vaccine Innovation and Access, PATH, Seattle, WA, USA.
Program for Appropriate Technology in Health · USCenters for Disease Control and Prevention · USLondon School of Hygiene & Tropical Medicine · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMiddle-income countries (MICs) that are not eligible for funding from Gavi, the Vaccine Alliance, have been slow to adopt rotavirus vaccines. Few studies have evaluated the cost-effectiveness and benefit-risk of rotavirus vaccination in these settings. We aimed to assess the potential economic and health impact of rotavirus vaccination in 63 MICs not eligible for funding from Gavi.

methodsIn this modelling study, we estimated the cost-effectiveness and benefit-risk of rotavirus vaccination in 63 MICs not eligible to Gavi funding. We used an Excel-based proportionate outcomes model with a finely disaggregated age structure to estimate the number of rotavirus gastroenteritis cases, clinic visits, hospitalisations, and deaths averted by vaccination in children younger than 5 years over a 10-year period. We calculated cost-effectiveness ratios (costs per disability-adjusted life-years averted compared with no vaccination) and benefit-risk ratios (number of hospitalisations due to rotavirus gastroenteritis averted per excess hospitalisations due to intussusception). We evaluated three alternative vaccines available globally (Rotarix, Rotavac, and Rotasiil) and used information from vaccine manufacturers regarding anticipated vaccine prices. We ran deterministic and probabilistic uncertainty analyses.

findingsOver the period 2020-29, rotavirus vaccines could avert 77 million (95% uncertainty interval [UI] 51-103) cases of rotavirus gastroenteritis and 21 million (12-36) clinic visits, 3 million (1·4-5·6) hospitalisations, and 37 900 (25 900-55 900) deaths due to rotavirus gastroenteritis in 63 MICs not eligible for Gavi support. From a government perspective, rotavirus vaccination would be cost-effective in 48 (77%) of 62 MICs considered. The benefit-risk ratio for hospitalisations prevented versus those potentially caused by vaccination exceeded 250:1 in all countries.

interpretationIn most MICs not eligible for Gavi funding, rotavirus vaccination has high probability to be cost-effective with a favourable benefit-risk profile. Policy makers should consider this new evidence when making or revisiting decisions on the use of rotavirus vaccines in their respective countries.

fundingBill & Melinda Gates Foundation.

Indexed as

Developing CountriesChild, PreschoolCost-Benefit AnalysisHumansInfantModels, TheoreticalRisk AssessmentRotavirus InfectionsRotavirus VaccinesVaccinationRotavirus Vaccines

Identifiers

PMID33891885
PMCPMC8205857
OpenAlexW3156550707

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.