OBJECTIVES :

Rotavirus gastroenteritis (RVGE) remains a significant health concern in China. Nearly all children will experience at least one rotavirus infection by age 5. While many cases are asymptomatic or mild, approximately 5 per 100,000 children under 5 years of age die due to RVGE. Furthermore, 47.8% of the acute gastroenteritis hospitalizations among children under 5 are due to RVGE. While some rotavirus vaccines are available within China, they remain under-utilized and there is a low suspected degree of vaccine effectiveness. In this study, we project the potential impact of vaccination with RotaTeq, a pentavalent rotavirus vaccine for serotypes G1-G4 and G9, on the incidence and healthcare burden of RVGE in China.

METHODS :

A Markov model was adapted to project the number and severity of symptomatic RVGE cases during the first 5 years of life in a birth cohort of 15,230,000 infants in China. Projections were made under two alternative scenarios: (1) no rotavirus vaccine was administered and (2) RotaTeq vaccine was administered under a private market vaccination campaign (assuming a 50% coverage rate with vaccine effectiveness based on the Rotavirus Efficacy and Safety Trial). Probabilistic sensitivity analyses were conducted to evaluate the impact of parameter uncertainty on the model projections.

RESULTS :

The results indicate that vaccination is projected to reduce symptomatic RVGE cases by 28.7% (95% confidence interval: 20.57% – 35.7%) and to avoid 2,857,814 symptomatic infections in a cohort of infants followed for 5 years. Office visits and hospitalizations are expected to decline by 41.8% and 48.7%, respectively. Deaths due to RVGE are projected to decline by 48.7% (from 3,778 to 1,938).

CONCLUSIONS

A vaccination strategy with RotaTeq (under a 50% coverage rate assumption) is projected to significantly reduce RVGE morbidity and mortality in China.