Medium- to Long-Term Impact of Rotavirus Vaccination on Hospital Care in Belgium: A 7-Year Follow-Up of the Rotavirus Belgium Impact Study (RotaBIS)

Abstract

IntroductionRotavirus (RV) vaccination was introduced in Belgium in 2006. With the high uptake it had (>85%), a sharp decline in hospitalizations was observed during the first years after vaccine introduction. The objective of this study was to investigate whether this decline was maintained and to simulate projections.MethodsThe Rotavirus Belgium Impact Study allowed an analysis of the RV vaccine impact amongst children in 11 hospitals in Belgium over a 9-year period (2005–2013) with 2 years pre- and 7 years post-vaccine introduction. Results were compared by year and by subsequent birth cohort aging up to 5 years. The two different analysis methods helped dismantling the different (direct and indirect) effects of vaccine protection to simulate future hospitalization trends.ResultsDuring the whole observation period, 40,552 RV detection tests were performed of which 5832 were positive (14.4%). After RV vaccine introduction, a significant reduction in number of tests performed (−38%) was combined with a dramatic drop in numbers of positive tests (−76.6%). The decreases were spectacular during the first two years of vaccine introduction; after that period, the decrease flattened. Cross-sectional comparison with cohort data showed that the initial drop was heavily influenced by the herd effect of the vaccine. Cohort analysis demonstrated a low rate of residual disease over time, suggesting another infection source other than the child population.ConclusionThe residual disease will be maintained in the community when a same vaccination strategy is continued over time, starting vaccination of children only at 6 weeks’ time.FundingGlaxoSmithKline Biologicals SA.Trial registrationClinicalTrials.gov identifier, NCT01563146.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-015-0099-1) contains supplementary material, which is available to authorized users.

3. How comprehensive can we be in the economic assessment of vaccines?

“…The cauliflower tool will then indicate different florets to be explored, compared with an evaluation performed for a well-developed healthcare system. Our focus here is on the value assessment of the vaccine in a developed country such as Belgium, where this vaccine was introduced a few years ago [39]. …”

2. How is the economic assessment of vaccines performed today?

“…Vaccine impact is normally measured by comparing the vaccinated population against historical data or a separate unvaccinated population, usually in terms of reduction in disease events [19]. In contrast, vaccine effectiveness measurement needs a case-control evaluation design that is usually more complex to organise and to calculate [20].…”

Vaccination Against Rotavirus Infection: 10-Year Global Experience of Successful Use

“…В Бельгии групповой эффект оценивался по сокращению обращений за неотложной медицинской помощью на 40% в первый год после внедрения вакцина-ции против ротавируса и на 15% -во второй год после расширения педиатрического графика иммунизации [71].…”