Rotavirus Vaccination: Cost-Effectiveness and Impact on Child Mortality in Developing Countries

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Richard Rheingans Ph.D., Department Chair (Creator)
Appalachian State University (ASU )
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Abstract: Background. Rotavirus is the leading cause of severe gastroenteritis in children !5 years of age and is responsible for 1500,000 deaths annually; 85% of this burden is in low-income countries eligible for financial support from the GAVI Alliance. We projected the uptake, health impact, and cost-effectiveness of introducing rotavirus vaccination in GAVI-eligible countries to help policy makers in prioritizing resources to gain the greatest healthimprovements for their constituencies.Methods. A demand forecast model was used to predict adoption of rotavirus vaccine in the poorest countries in the world. We then modeled health outcomes and direct costs of a hypothetical birth cohort in the target population for scenarios with and without a rotavirus vaccine with use of data on health outcomes of rotavirus infection, vaccine effectiveness, and immunization rates.Results. Vaccination would prevent 2.4 million rotavirus deaths and 182 million disability-adjusted life-years (DALYs) in 64 of the 72 GAVI-eligible countries introducing vaccine from 2007 through 2025. The cost per DALY averted decreases over time, from a high of US$450 per DALY averted in the first year to a sustained low of $30 per DALY during 2017–2025, with a cumulative figure of $43 per DALY averted during 2008–2025. By applyingthe baseline scenario with an initial vaccine price of $7 per dose for a 2-dose vaccine, with a gradual decrease beginning in 2012 and stabilizing at $1.25 per dose by 2017, vaccination was very cost-effective in all GAVI-eligible countries with use of each country’s gross domestic product per DALY averted as a threshold. Conclusions. Introduction of rotavirus vaccines into the world’s poorest countries is very cost-effective and is projected to substantially reduce childhood mortality

Additional Information

Richard D. Rheingans, Deborah Atherly, Robert Dreibelbis, Umesh D. Parashar, Carol Levin & John Wecker (2009) "Rotavirus Vaccination: Cost-Effectiveness and Impact on Child Mortality in Developing Countries" Journal of Infectious Diseases issue 200 pp. S28-S38 Version of Record Available From
Language: English
Date: 2009
Rotavirus, child mortality, GAVI

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