Spatio-temporal impact of self-financed rotavirus vaccination on rotavirus and acute gastroenteritis hospitalisations in
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(2020) 20:656
RESEARCH ARTICLE
Open Access
Spatio-temporal impact of self-financed rotavirus vaccination on rotavirus and acute gastroenteritis hospitalisations in the Valencia region, Spain Mónica López-Lacort1* , Alejandro Orrico-Sánchez1, Miguel Ángel Martínez-Beneito2,3, Cintia Muñoz-Quiles1 and Javier Díez-Domingo1
Abstract Background: Several studies have shown a substantial impact of Rotavirus (RV) vaccination on the burden of RV and all-cause acute gastroenteritis (AGE). However, the results of most impact studies could be confused by a dynamic and complex space-time process. Therefore, there is a need to analyse the impact of RV vaccination on RV and AGE hospitalisations in a space-time framework to detect geographical-time patterns while avoiding the potential confusion caused by population inequalities in the impact estimations. Methods: A retrospective population-based study using real-world data from the Valencia Region was performed among children aged less than 3 years old in the period 2005–2016. A Bayesian spatio-temporal model was constructed to analyse RV and AGE hospitalisations and to estimate the vaccination impact measured in averted hospitalisations. Results: We found important spatio-temporal patterns in RV and AGE hospitalisations, RV vaccination coverage and in their associated adverted hospitalisations. Overall, ~ 1866 hospital admissions for RV were averted by RV vaccination during 2007–2016. Despite the low-medium vaccine coverage (~ 50%) in 2015–2016, relevant 36 and 20% reductions were estimated in RV and AGE hospitalisations respectively. Conclusions: The introduction of the RV vaccines has substantially reduced the number of RV hospitalisations, averting ~ 1866 admissions during 2007–2016 which were space and time dependent. This study improves the methodologies commonly used to estimate the RV vaccine impact and their interpretation. Keywords: Rotavirus, Vaccine impact, Spatio-temporal, Real-world data, Bayesian model
Background Rotavirus (RV) is the leading cause of gastroenteritis in children < 5 years of age worldwide [1]. Prior to the license of the two live-attenuated rotavirus vaccines (RV1; Rotarix®, GSK and RV5; RotaTeq®, MSD) in 2006 and 2007, respectively, RV infection caused approximately * Correspondence: [email protected] 1 Vaccine Research Department FISABIO-Public Health, Avenida Cataluña, 21, 46020 Valencia, Spain Full list of author information is available at the end of the article
138 million episodes of acute gastroenteritis (AGE) per year (~ 2 million hospitalisations), of which ~ 3.6 million (~ 87,000 hospitalisations) occurred in Europe [2]. The World Health Organization (WHO) recommended including RV vaccination worldwide. The recommended schedule is two (RV1) or three (RV5) oral doses and should be completed between 6 and 32 weeks of age. Currently, 98 countries have introduced RV vaccines into their national immunisation programs [3]. This measure has had a major impact on the burden of
© The Author(s). 2020 Open Access This article is licensed
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