Real-world impact of rotavirus vaccination in European healthcare settings: a systematic literature review

ABSTRACT

Introduction

Rotavirus is one of the most common pathogens causing diarrhea in children <5 years and has a major impact on childhood morbidity and mortality. Since the implementation of rotavirus vaccines into childhood immunization programs across Europe, there has been a reduction in rotavirus burden, including hospitalizations, outpatient cases, costs, and deaths.

Areas covered

A systematic literature review identified publications describing the clinical and economic impact of rotavirus vaccinations across Europe, from their introduction in 2006 to the end of 2020. A total of 3,137 articles were identified, of which 46 were included in the review. Included articles reported the impact of rotavirus vaccination on disease in any age group.

Expert opinion

Rotavirus vaccination has resulted in substantial reductions in hospitalizations and rotavirus-associated costs across Europe, particularly in children <5 years. There is some evidence of herd protection afforded to older age groups where vaccine uptake is high among infants, highlighting the potential for vaccination to confer a greater societal benefit as programs become more established. Increasing vaccination coverage and continuing investment in widespread rotavirus vaccination programs across countries will likely increase the substantial public health benefits associated with vaccination and further reduce the clinical and economic burden of disease.

KEYWORDS:

• Children
• diarrhea
• gastroenteritis
• rotavirus
• systematic literature review
• vaccines

Article highlights

• Rotavirus vaccination reduces the clinical and economic burden of diarrheal disease

• Beneficial effects are most substantial in younger populations (<5 years)

• Some studies indicate herd protection for older children after infant vaccination

• Future research should continue to document vaccine impact as coverage increases

Author contributions

All authors substantially contributed to the conception and design of the study and interpretation of the relevant literature. All authors were involved in the writing of the manuscript or revision of the manuscript for intellectual content.

Declaration of interests

G Bencina, U Sabale, J Murtagh and C Carias are employees of MSD subsidiaries of Merck & Co., Inc., Kenilworth, NJ, USA, the manufacturer of the rotavirus oral vaccine and may own stocks and/or stock options. A Ahern, R Bhaila, and R Newman are employees of Adelphi Values PROVE™. Adelphi Values PROVE™ was compensated by MSD for the conduct of the study and development of the manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have received an honorarium from Expert Review of Vaccines for their review work but have no other relevant financial relationships to disclose.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials. Written requests can be sent to the corresponding author.

Supplementary material

Supplemental data for this article can be accessed here

Additional information

Funding

This manuscript was funded by Merck & Co., Inc., Kenilworth, NJ, USA. The funder contributed to the design of the study, collection, analysis, and interpretation of data as well as the writing and revision of the manuscript.