Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Int J Infect Dis. 2023 Dec;137:90-97. doi: 10.1016/j.ijid.2023.10.005. Epub 2023 Oct 18.
We estimated the global impact of rotavirus vaccines on deaths among children under five years old by year.
We used a proportionate outcomes model with a finely disaggregated age structure to estimate rotavirus deaths prevented by vaccination over the period 2006-2019 in 186 countries. We ran deterministic and probabilistic uncertainty analyses and compared our estimates to surveillance-based estimates in 20 countries.
We estimate that rotavirus vaccines prevented 139,000 under-five rotavirus deaths (95% uncertainty interval 98,000-201,000) in the period 2006-2019. In 2019 alone, rotavirus vaccines prevented 15% (95% uncertainty interval 11-21%) of under-five rotavirus deaths (0.5% of child mortality). Assuming global use of rotavirus vaccines and coverage equivalent to other co-administered vaccines could prevent 37% of under-five rotavirus deaths (1.2% of child mortality). Our estimates were sensitive to the choice of rotavirus mortality burden data and several vaccine impact modeling assumptions. The World Health Organization's recommendation to remove age restrictions in 2012 could have prevented up to 17,000 rotavirus deaths in the period 2013-2019. Our modeled estimates of rotavirus vaccine impact were broadly consistent with estimates from post-vaccination surveillance sites.
Rotavirus vaccines have made a valuable contribution to global public health. Enhanced rotavirus mortality prevention strategies are needed in countries with high mortality in under-5-year-old children.
我们按年份估计了轮状病毒疫苗对五岁以下儿童死亡人数的全球影响。
我们使用了一个具有精细分解年龄结构的比例结果模型，来估计 2006 年至 2019 年期间 186 个国家因疫苗接种而预防的轮状病毒死亡人数。我们进行了确定性和概率性不确定性分析，并将我们的估计与 20 个国家的监测为基础的估计进行了比较。
我们估计，2006 年至 2019 年期间，轮状病毒疫苗预防了 139,000 例五岁以下轮状病毒死亡（95%置信区间 98,000-201,000）。仅在 2019 年，轮状病毒疫苗就预防了 15%（95%置信区间 11-21%）的五岁以下轮状病毒死亡（占儿童死亡率的 0.5%）。假设全球使用轮状病毒疫苗，并达到与其他共同接种疫苗的覆盖率，可预防 37%的五岁以下轮状病毒死亡（占儿童死亡率的 1.2%）。我们的估计对轮状病毒死亡率负担数据的选择和几种疫苗影响建模假设较为敏感。世界卫生组织在 2012 年建议取消年龄限制，这可能使 2013 年至 2019 年期间的轮状病毒死亡人数减少多达 17,000 人。我们对轮状病毒疫苗影响的模型估计与疫苗接种后监测点的估计基本一致。
轮状病毒疫苗为全球公共卫生做出了宝贵贡献。在五岁以下儿童死亡率较高的国家，需要加强轮状病毒死亡率预防策略。
