Introducing rotavirus vaccine in the Universal Immunization Programme in India: From evidence to policy to implementation

Malik, Akash; Haldar, Pradeep; Ray, Arindam; Shet, Anita; Kapuria, Bhrigu; Bhadana, Sheenu; Santosham, Mathuram; Ghosh, Raj Shankar; Steinglass, Robert; Kumar, Rajinder

doi:10.1016/j.vaccine.2019.07.104

Cited by 45 publications

(30 citation statements)

References 13 publications

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“…India has a robust national immunization program for early childhood that has been strengthened recently with demonstrable gains in vaccination coverage ( Gurnani et al, 2018 ). The recent introduction and rollout of the pneumococcal conjugate vaccine and rotavirus vaccine have shown that new vaccines can be successfully rolled out within existing public health infrastructure ( Malik et al, 2019 ). While a clear strategy for childhood vaccination exists globally and in India, a blueprint for adult immunization is recognizably inadequate and is being increasingly acknowledged as important for sustaining and enhancing health outcomes ( Privor-Dumm et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Comparing COVID-19 vaccine allocation strategies in India: A mathematical modelling study

Foy

Wahl

Mehta

et al. 2021

International Journal of Infectious Diseases

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151

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Section: Discussionmentioning

confidence: 99%

Comparing COVID-19 vaccine allocation strategies in India: A mathematical modelling study

Foy

Wahl

Mehta

et al. 2021

International Journal of Infectious Diseases

Self Cite

219

151

View full text Add to dashboard Cite

“…India has a robust national immunization program for early childhood that has been strengthened recently with demonstrable and striking gains in vaccination coverage (Gurnani et al 2018). The recent introduction and rollout of the pneumococcal conjugate vaccine and rotavirus vaccine have shown that new vaccines can be successfully rolled out within existing public health infrastructure (Malik et al 2019). While a clear strategy for childhood vaccination exists globally and in India, a blueprint for adult immunization is recognizably inadequate and is being increasingly acknowledged as important for sustaining and enhancing health outcomes, as well as social and economic outcomes Due to data availability constraints, and evolving scientific understanding of COVID-19, the model makes a number of key assumptions about transmission dynamics.…”

Section: Discussionmentioning

confidence: 99%

Comparing COVID-19 vaccine allocation strategies in India: a mathematical modelling study

Foy

Wahl

Mehta

et al. 2020

Preprint

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BackgroundThe development and widespread use of an effective SARS-CoV-2 vaccine could help prevent substantial morbidity and mortality associated with COVID-19 infection and mitigate many of the secondary effects associated with non-pharmaceutical interventions. The limited availability of an effective and licensed vaccine will task policymakers around the world, including in India, with decisions regarding optimal vaccine allocation strategies. Using mathematical modelling we aimed to assess the impact of different age-specific COVID-19 vaccine allocation strategies within India on SARS CoV-2-related mortality and infection.MethodsWe used an age-structured, expanded SEIR model with social contact matrices to assess different age-specific vaccine allocation strategies in India. We used state-specific age structures and disease transmission coefficients estimated from confirmed Indian incident cases of COVID-19 between 28 January and 31 August 2020. Simulations were used to investigate the relative reduction in mortality and morbidity of vaccinate allocation strategies based on prioritizing different age groups, and the interactions of these strategies with several concurrent non-pharmacologic interventions (i.e., social distancing, mandated masks, lockdowns). Given the uncertainty associated with current COVID-19 vaccine development, we also varied several vaccine characteristics (i.e., efficacy, type of immunity conferred, and rollout speed) in the modelling simulations.ResultsIn nearly all scenarios, prioritizing COVID-19 vaccine allocation for older populations (i.e., >60yrs old) led to the greatest relative reduction in deaths, regardless of vaccine efficacy, control measures, rollout speed, or immunity dynamics. However, preferential vaccination of this target group often produced higher total symptomatic infection counts and more pronounced estimates of peak incidence than strategies which targeted younger adults (i.e., 20-40yrs or 40-60yrs) or the general population irrespective of age. Vaccine efficacy, immunity type, target coverage and rollout speed all significantly influenced overall strategy effectiveness, with the time taken to reach target coverage significantly affecting the relative mortality benefit comparative to no vaccination.ConclusionsOur findings support global recommendations to prioritize COVID-19 vaccine allocation for older age groups. Including younger adults in the prioritisation group can reduce overall infection rates, although this benefit was countered by the larger mortality rates in older populations. Ultimately an optimal vaccine allocation strategy will depend on vaccine characteristics, strength of concurrent non-pharmaceutical interventions, and region-specific goals such as reducing mortality, morbidity, or peak incidence.

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“…In India, the indigenously developed Rotavac vaccine, based on the human-bovine reassortant neonatal attenuated 116E strain, is a monovalent vaccine with the genotypic composition G9P [ 11 ]. It was introduced to the Universal Immunization Program (UIP) in April 2016 in a phased manner [ 11 ]. Other rotavirus vaccines like Rotateq and Rotarix were available in the private sectors for immunization before nationwide rotavirus vaccine implementation.…”

Section: Introductionmentioning

confidence: 99%

Rotavirus Strain Distribution before and after Introducing Rotavirus Vaccine in India

et al. 2021

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In April 2016, an indigenous monovalent rotavirus vaccine (Rotavac) was introduced to the National Immunization Program in India. Hospital-based surveillance for acute gastroenteritis was conducted in five sentinel sites from 2012 to 2020 to monitor the vaccine impact on various genotypes and the reduction in rotavirus positivity at each site. Stool samples collected from children under 5 years of age hospitalized with diarrhea were tested for group A rotavirus using a commercial enzyme immunoassay, and rotavirus strains were characterized by RT-PCR. The proportion of diarrhea hospitalizations attributable to rotavirus at the five sites declined from a range of 56–29.4% in pre-vaccine years to 34–12% in post-vaccine years. G1P[8] was the predominant strain in the pre-vaccination period, and G3P[8] was the most common in the post-vaccination period. Circulating patterns varied throughout the study period, and increased proportions of mixed genotypes were detected in the post-vaccination phase. Continuous long-term surveillance is essential to understand the diversity and immuno-epidemiological effects of rotavirus vaccination.

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Introducing rotavirus vaccine in the Universal Immunization Programme in India: From evidence to policy to implementation

Cited by 45 publications

References 13 publications

Comparing COVID-19 vaccine allocation strategies in India: A mathematical modelling study

Comparing COVID-19 vaccine allocation strategies in India: A mathematical modelling study

Comparing COVID-19 vaccine allocation strategies in India: a mathematical modelling study

Rotavirus Strain Distribution before and after Introducing Rotavirus Vaccine in India

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