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轮状病毒疫苗接种对中国的健康影响。

Health impact of rotavirus vaccination in China.

机构信息

BARDS-HEDS, Merck & Co. Inc., Rahway, NJ, USA.

HEOR, Analysis Group, Beijing, China.

出版信息

Hum Vaccin Immunother. 2024 Dec 31;20(1):2386750. doi: 10.1080/21645515.2024.2386750. Epub 2024 Sep 13.

DOI:10.1080/21645515.2024.2386750
PMID:39269780
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11404606/
Abstract

Rotavirus (RV) vaccines have demonstrated substantial effectiveness in reducing the healthcare burden caused by gastroenteritis (RVGE) worldwide. This study aims to understand the differential impact of RV vaccination in reducing RVGE burden in children under 7 years old in China. A Markov Model was used to investigate the health impact of introducing two different RV vaccines into the Chinese population. The analysis was conducted for RV5, a live pentavalent human-bovine reassortant vaccine, and Lanzhou Lamb RV (LLR), a live-attenuated monovalent RV vaccine, separately, by comparing the strategy of each vaccine to no vaccination within a Chinese birth cohort, including 100,000 children modeled until 7 years of age. The vaccination scenario assumed a vaccination coverage of 2.5%, 2.5%, 90% and 5% for doses one, two, three and no vaccine, respectively, for both vaccines. Strategies with RV5, LLR, and no vaccination were associated with 9,895, 49,069, and 64,746 symptomatic RV infections, respectively. RV5 and LLR were associated with an 85% and 24% reduction in the total symptomatic RV infections, respectively, suggesting that the health benefits of RV5 are at least three-fold greater than those associated with the LLR. Further, strategies with RV5 and LLR resulted in an estimated 206 and 59-year increase in quality-adjusted life years (QALYs), respectively. Sensitivity and scenario analyses supported the robustness of the base-case findings. Use of RV vaccine is expected to improve RV-associated health outcomes and its adoption will help alleviate the burden of RVGE in China. RV5 use will result in significantly better health outcomes.

摘要

轮状病毒 (RV) 疫苗已被证明在全球范围内显著降低了由肠胃炎 (RVGE) 引起的医疗保健负担。本研究旨在了解 RV 疫苗接种对降低中国 7 岁以下儿童 RVGE 负担的差异影响。使用马尔可夫模型来研究引入两种不同 RV 疫苗对中国人群的健康影响。分别对 RV5(一种五价人-牛重组活疫苗)和兰州羔羊 RV(LLR),一种单价减毒活 RV 疫苗进行分析,通过比较每种疫苗与中国出生队列中的无疫苗接种策略,包括 100,000 名建模至 7 岁的儿童。疫苗接种方案假设两种疫苗的接种覆盖率分别为 2.5%、2.5%、90%和 5%,剂量分别为 1、2、3 和无疫苗。RV5、LLR 和无疫苗接种策略分别与 9895、49069 和 64746 例有症状 RV 感染相关。RV5 和 LLR 分别与总症状性 RV 感染减少 85%和 24%相关,表明 RV5 的健康获益至少是 LLR 的三倍。此外,RV5 和 LLR 策略估计分别导致质量调整生命年 (QALY) 增加 206 和 59 年。敏感性和情景分析支持了基础案例结果的稳健性。RV 疫苗的使用有望改善 RV 相关的健康结果,其采用将有助于减轻中国 RVGE 的负担。使用 RV5 将带来显著更好的健康结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb91/11404606/1271a8ab0c9d/KHVI_A_2386750_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb91/11404606/0b50bd2786a0/KHVI_A_2386750_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb91/11404606/1271a8ab0c9d/KHVI_A_2386750_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb91/11404606/0b50bd2786a0/KHVI_A_2386750_F0001_B.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb91/11404606/1271a8ab0c9d/KHVI_A_2386750_F0002_OC.jpg

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Effectiveness of Pentavalent Rotavirus Vaccine in Shanghai, China: A Test-Negative Design Study.中国上海五价轮状病毒疫苗的有效性:一项似然比阴性设计研究。
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