Vaccine Investigation Area, CSISP Centre for Public Health Research, Avda Catalunya 21, Valencia 46020, Spain.
BMC Public Health. 2010 Aug 10;10:469. doi: 10.1186/1471-2458-10-469.
Rotavirus is the most common cause of gastroenteritis in young children worldwide. The aim of the study was to assess the health outcomes and the economic impact of a universal rotavirus vaccination programme with RotaTeq, the pentavalent rotavirus vaccine, versus no vaccination programme in Spain.
A birth cohort was followed up to the age of 5 using a cohort model. Epidemiological parameters were taken from the REVEAL study (a prospective epidemiological study conducted in Spain, 2004-2005) and from the literature. Direct and indirect costs were assessed from the national healthcare payer and societal perspectives by combining health care resource utilisation collected in REVEAL study and unit costs from official sources. RotaTeq per protocol efficacy data was taken from a large worldwide rotavirus clinical trial (70,000 children). Health outcomes included home care cases, General Practioner (GP)/Paediatrician, emergency department visits, hospitalisations and nosocomial infections.
The model estimates that the introduction of a universal rotavirus vaccination programme with RotaTeq (90% coverage rate) would reduce the rotavirus gastroenteritis (RVGE) burden by 75% in Spain; 53,692 home care cases, 35,187 GP/Paediatrician visits, 34,287 emergency department visits, 10,987 hospitalisations and 2,053 nosocomial infections would be avoided. The introduction of RotaTeq would avoid about 76% of RVGE-related costs from both perspectives: euro22 million from the national health system perspective and euro38 million from the societal perspective.
A rotavirus vaccination programme with RotaTeq would reduce significantly the important medical and economic burden of RVGE in Spain.
轮状病毒是全球儿童中最常见的引起肠胃炎的原因。本研究旨在评估在西班牙,使用五价轮状病毒疫苗(RotaTeq)进行普遍轮状病毒疫苗接种计划与不进行疫苗接种计划相比对健康结果和经济影响。
采用队列模型对出生队列进行随访,直至 5 岁。流行病学参数取自 REVEAL 研究(2004-2005 年在西班牙进行的一项前瞻性流行病学研究)和文献。从国家卫生保健支付方和社会角度,通过结合 REVEAL 研究中收集的卫生保健资源利用情况和官方来源的单位成本,评估直接和间接成本。根据一项大型全球轮状病毒临床试验(70000 名儿童),采用 RotaTeq 方案疗效数据。健康结果包括家庭护理病例、全科医生/儿科医生就诊、急诊就诊、住院和医院感染。
模型估计,在西班牙实施普遍的 RotaTeq 轮状病毒疫苗接种计划(覆盖率 90%),将使轮状病毒肠胃炎(RVGE)负担减少 75%;将避免 53692 例家庭护理病例、35187 例全科医生/儿科医生就诊、34287 例急诊就诊、10987 例住院和 2053 例医院感染。从国家卫生系统和社会角度来看,引入 RotaTeq 将避免约 76%的 RVGE 相关费用。
RotaTeq 轮状病毒疫苗接种计划将显著降低西班牙 RVGE 的重要医疗和经济负担。