Assessment of reduction of rotavirus infection burden in case of vaccination with a pentavalent vaccine in Russian Federation

Rotavirus is the major cause of severe acute gastroenteritis in children under 5 years. Vaccination with a pentavalent rotavirus vaccine significantly reduces incidence of rotavirus infection.

Goal: assessment of reduction of rotavirus infection burden in case of vaccination with a pentavalent vaccine in Russian Federation.

Methods. Modeling based on results of clinical studies of rotavirus immunization and epidemiological data from Russia has been established. Analysis has been done from the position of the healthcare system (only direct medical costs) and from the social perspective (analysis of direct medical and indirect costs) with 10 years horizon. The analysis carried out for selective and routine vaccination. In case of routine vaccination herd effect has been taken into consideration. Direct medical costs were estimated based on 2013 Obligatory State Insurance tariffs in St. Petersburg.

Results and discussion. Routine vaccination can prevent 1394 cases of rotavirus infection in ambulatory settings and 686 cases of rotavirus-associated inpatient admissions per 100 000 vaccinated infants. As a whole across the Russian Federation in 10 years 2,22 million cases of rotavirus infection treated in ambulatory settings and 1.09 million of rotavirus-associated inpatients admission will be prevented. Vaccination save 1,26K rubles per child for the healthcare system of Russian Federation and 2,85K rubles per child if indirect costs are included. Annual vaccination of 95% of newborns against an rotavirus infection will allow to lower the disease burden within the first 10 years after the beginning of routine vaccination on 45,31 billion rubles, from them 18,98 billion rubles – costs of outpatient cases, and 26,33 billion rubles – costs of inpatient cases. The prevented expenses of healthcare system will make 20,04 billion rubles, the prevented indirect costs – 25,27 billion rubles.

Conclusion. Vaccination by a 5-valent vaccine against rotavirus infection not only will reduce its incidence in the Russian Federation, but also will significantly reduce costs in ambulatory and inpatient settings. Routine vaccination is economically more preferable in comparison to selected groups’ vaccination due to development of herd effect, despite need of increase in healthcare budget.

1. Vasil’ev B.Ja., Vasil’eva R.I., Lobzin Ju.V. Ostrye kishechnye zabolevanija. Rotavirusy i rotavirusnaja infekcija. — SPb., 2000.

2. Podkolzin A., Fenske E., Abramycheva N., et al. Pokrovsky Hospital-Based Surveillance of Rotavirus and Other Viral Agents of Diarrhea in Children and Adults in Russia, 2005– 2007 // The Journal of Infectious Diseases 2009; 200: S228–33.

3. Zhirakovskaja E.V., Nikiforova N.A., Korsakova T.G. i dr. Rotavirusnaja infekcija u detej rannego vozrasta v Novosibirske: genotipirovanie cirkulirujushhih izoljatov // Jepidemiol. i infekc. bol. 2007; 3: 32-36.

4. Gorbunova M., Zhirakovskaja E., Tikunova N., i dr. Harakteristika jepidemiologicheskogo processa rotavirusnoj infekcii na territorii Omskoj oblasti v 1993-2007 godah // Sibirskij medicinskij zhurnal 2008; 7: 113-116.

5. Podkolzin A.T., Fenske E.B., Abramycheva N.Ju. i dr. Nadzor za rotavirusnoj infekciej po dannym gospitalizacii v otdel'nyh gorodah RF za 2005-2007 gg. // Infekcionnye bolezni 2008; 6(4): 28-31.

6. Prevention of Rotavirus Disease: Updated Guidelines for Use of Rotavirus Vaccine. Committee on Infectious Diseases //Pediatrics 2009; 123: 1412 - 1420.

7. Chodick G., Waisbourd-Zinman O., Shalev V., et al. Potential impact and cost-effectiveness analysis of rotavirus vaccination of children in Israel // Eur J Public Health 2009; 19: 254 - 259.

8. Lopman B., Curns A., Yen C., Parashar U. Infant rotavirus vaccination may provide indirect protection to older children and adults in the United States // The Journal of Infectious Diseases 2011; 204: 980–6.

9. Payne D., Staat M., Edwards K., et al. Direct and indirect effects of rotavirus vaccination upon childhood hospitalizations in 3 US Counties, 2006–2009 // Clinical Infectious Diseases 2011; 53 (3): 245–253.

10. Field E.J., Vally H., Grimwood K., Lambert SB. Pentavalent rotavirus vaccine and prevention of gastroenteritis hospitalizations in Australia // Pediatrics 2010; 126: e506–12.