Model-based estimation of the impact on rotavirus disease of RV3-BB vaccine administered in a neonatal or infant schedule

ABSTRACT

Rotavirus infection is a common cause of severe diarrheal disease and a major cause of deaths and hospitalizations among young children. Incidence of rotavirus has declined globally with increasing vaccine coverage. However, it remains a significant cause of morbidity and mortality in low-income countries where vaccine access is limited and efficacy is lower. The oral human neonatal vaccine RV3-BB can be safely administered earlier than other vaccines, and recent trials in Indonesia have demonstrated high efficacy. In this study, we use a stochastic individual-based model of rotavirus transmission and disease to estimate the anticipated population-level impact of RV3-BB following delivery according to either an infant (2, 4, 6 months) and neonatal (0, 2, 4 months) schedule. Using our model, which incorporated an age- and household-structured population and estimates of vaccine efficacy derived from trial data, we found both delivery schedules to be effective at reducing infection and disease. We estimated 95–96% reductions in infection and disease in children under 12 months of age when vaccine coverage is 85%. We also estimate high levels of indirect protection from vaccination, including 78% reductions in infection in adults over 17 years of age. Even for lower vaccine coverage of 55%, we estimate reductions of 84% in infection and disease in children under 12 months of age. While open questions remain about the drivers of observed lower efficacy in low-income settings, our model suggests RV3-BB could be effective at reducing infection and preventing disease in young infants at the population level.

KEYWORDS:

• Rotavirus
• RV3-BB vaccine
• neonatal schedule
• Indonesia
• individual-based model

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

Deidentified group data may be available for sharing on application via the corresponding author. This application must include the relevant proposal detailing the intended use of the data, the ethics approval for this proposal and requires a signed data sharing agreement. Additional study documents including the study protocol, statistical analysis plan and informed consent are available on application via the corresponding author on publication of this report.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website at https://doi.org/10.1080/21645515.2022.2139097

Additional information

Funding

This research at MCRI was supported by the Victorian Government’s Operational Infrastructure Support Program. JMcV is supported by an NHMRC Principal Research Fellowship. MCRI holds the patent for RV3-BB vaccine. This work was supported, in whole or in part, by the Bill & Melinda Gates Foundation (OPP1111055). Under the grant conditions of the Foundation, a Creative CommonsAttribution 4.0 Generic License has already been assigned to the AuthorAccepted Manuscript version that might arise from this submission.