Universal rotavirus vaccination program in Sicily: Reduction in health burden and cost despite low vaccination...

Area of Science:

• Pediatric infectious diseases
• Public health policy
• Health economics

Background:

• Rotavirus is a leading cause of severe gastroenteritis in children, particularly in pediatric units.
• Late winter and early spring are peak seasons for rotavirus in temperate climates.
• Sicily introduced universal rotavirus vaccination in 2013, marking a first for Italy.

Purpose of the Study:

• To assess the health and economic impact of rotavirus gastroenteritis (RVGE) in children under 59 months in Sicily post-vaccine introduction.
• To analyze hospitalization trends and healthcare costs associated with RVGE before and after vaccination.
• To evaluate the effectiveness of rotavirus vaccination in a region with suboptimal coverage (<50%).

Main Methods:

• Analysis of hospital discharge records for RVGE (ICD-9-CM code 008.61) in children aged 0-59 months in Sicily from 2009-2016.
• Comparison of hospitalization rates and seasonal patterns in the pre-vaccination (2009-2012) and post-vaccination (2013-2016) periods.
• Estimation of direct, indirect, and vaccination costs to determine economic impact on the regional health system.

Main Results:

• A notable decrease in RVGE hospitalizations was observed, dropping from 394 to 220 per 100,000 children.
• The peak season for reported RVGE cases shifted by at least one month, from March-April to May-June.
• Annual average cost savings were estimated at €1,134,056, considering all relevant healthcare and vaccination expenses.

Conclusions:

• Rotavirus vaccination in Sicily has led to a significant reduction in RVGE hospitalizations among young children.
• The vaccination program demonstrates a positive impact on healthcare cost savings, even with coverage below 50%.
• This study provides valuable insights into the health and economic benefits of rotavirus vaccination in a high-income setting with specific coverage challenges.