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Rotavirus Vaccination of Infants Delayed and Limited within the National Immunization Programme in the Netherlands:
Florian Zeevat1, Evgeni Dvortsin2, Abrham Wondimu1,3
1Department of Health Sciences, University Medical Centre, University of Groningen, 9713 AV Groningen, The Netherlands.
Insights
Implementing rotavirus vaccination in the Netherlands in 2006 could have prevented over 350,000 infant cases of rotavirus gastroenteritis. Universal vaccination offered the most significant health and economic benefits, representing a missed opportunity.
Area of Science:
- Pediatric infectious diseases
- Vaccine economics
- Public health policy
Background:
- Rotavirus gastroenteritis poses a significant health burden on infants.
- The Netherlands did not introduce rotavirus vaccination in 2006 despite market authorization.
Purpose of the Study:
- To estimate the potential public health and economic benefits of rotavirus vaccination in the Netherlands had it been introduced in 2006.
- To compare universal versus targeted high-risk group vaccination strategies.
Main Methods:
- An age-structured, deterministic cohort model simulated 15 years (2006-2021) of rotavirus vaccination impact.
- The model included 2.6 million infants and 13.2 million older children, analyzing scenarios for vaccine protection duration and herd immunity.
- Costs and quality-adjusted life years (QALYs) were calculated and discounted.
Main Results:
- Universal rotavirus vaccination could have prevented 356,800 cases (51% reduction) of rotavirus gastroenteritis.
- Targeted vaccination of high-risk infants could have prevented 32,200 cases (5% reduction).
- Both strategies demonstrated significant cost savings and QALY gains, with universal vaccination yielding superior outcomes.
Conclusions:
- Introducing rotavirus vaccination in 2006 would have provided substantial public health and economic benefits in the Netherlands.
- Universal vaccination emerged as the most effective strategy for disease prevention and QALY improvement.
- The delay in rotavirus vaccine introduction represents a missed opportunity for significant health gains.
Abstract:
In this study, we estimated the benefits of rotavirus vaccination for infants had the rotavirus vaccine been introduced in the Netherlands as of its market authorization in 2006. An age-structured, deterministic cohort model was developed to simulate different birth cohorts over a period of 15 years from 2006 until 2021, comparing both universal and targeted high-risk group vaccination to no vaccination. Different scenarios for the duration of protection (5 or 7 years) and herd immunity (only for universal vaccination) were analyzed. All birth cohorts together included 2.6 million infants, of which 7.9% were high-risk individuals, and an additional 13.2 million children between 1-15 years born prior to the first cohort in 2006. The costs and health outcomes associated with rotavirus vaccination were calculated per model scenario and discounted at 4% and 1.5%, respectively. Our analysis reveals that, had rotavirus vaccination been implemented in 2006, it would have prevented 356,800 (51% decrease) and 32,200 (5% decrease) cases of rotavirus gastroenteritis after universal and targeted vaccination, respectively. Over the last 15 years, this would have led to significant avoided costs and quality-adjusted life year losses for either vaccination strategy with the most favorable outcomes for universal vaccination. Clearly, an opportunity has been lost.
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