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

Figures & data

Figure 1. Schematic of the rotavirus infection and disease model to epidemiological data. Infants may be born with maternal immunity (M) or susceptible (S). Following contact and transmission with an infectious individual, susceptible individuals become exposed (E) and then infectious (I). Recovered individuals (R) are protected from further infection until their immunity wanes, and they once again become susceptible (S). Following successive exposures (denoted as subscripts 1, 2 and 3) individuals have different levels of susceptibility, infectiousness, and protection against disease (see Table 1). Black arrows denote transitions occurring due to infection and loss of immunity. Red arrows denote transitions occurring due to vaccination.

Table 1. Fixed parameter values and sources.

Parameter	Value	Reference
Mean duration of maternal immunity (M)	13 weeks	Linhares et al.^Citation13
Relative risk of infection (compared to S1) following:
First infection (S2)	0.62	Velázquez et al.^Citation14
Second and subsequent infections (S3)	0.37	Velázquez et al.^Citation14
Mean duration of latent period (E)	1 day	de Blasio et al.^Citation15
Proportion of infections with any RVGE (severe RVGE):
First infection (I1)	0.47 (0.13)	Pitzer et al.^Citation16
Second infection (I2)	0.25 (0.03)	Pitzer et al.^Citation16
Third and subsequent infections (I3)	0.2 (0.0)	Pitzer et al.^Citation16
Mean duration of infectiousness:
Severe RVGE	7 days	Ward et al.^Citation17
Mild RVGE/asymptomatic	3.5 days	Wilde et al.^Citation18
Relative infectiousness (compared to severe RVGE):
Mild RVGE	0.5	Koopman et al.^Citation19
Asymptomatic	0.2	Koopman et al.^Citation19
Mean duration of full immunity following recovery (R)	1 year	Chiba et al.^Citation20

Table 2. Contact rates for non-household contacts.

Parameter	Value
Mean daily number of non-household contacts	12 (0–3 years) 14 (4–16 years) 21 (17–49 years) 17 (50–65 years) 10 (65+ years)
Contact suppression weighting	1.0 (subclinical) 0.4 (mild disease) 0.05 (severe disease)

Table 3. Cumulative vaccine response.

	Infant Schedule	Neonatal Schedule
Dose 1	42%*	23%
Dose 2	87%	53%*
Dose 3	99%	94%

*Values may be underestimated due to absence of sera collection at this timepoint.

Figure 2. Annual incidence of all rotavirus infections, including asymptomatic infections, by age in the baseline, infant schedule and neonatal schedule scenarios. Incidence values are calculated over a five-year period, five years after the introduction of vaccination. Each boxplot shows the median, IQR and range over 10 simulation runs.

Figure 3. Impact of lower vaccine coverage. Annual incidence of all rotavirus infections, including asymptomatic infections, by age for baseline assumption of 85% vaccine coverage, and alternative moderate (55%) and low (25%) vaccine coverage scenarios. Incidence values are calculated over a five-year period, five years after the introduction of vaccination. Each boxplot shows the median, IQR and range over 10 simulation runs.

Figure 4. Impact of reduced maternal immunity on annual incidence when the probability of acquiring maternal immunity is halved. Annual incidence of all rotavirus infections, any disease, and severe disease only are shown for the baseline (no vaccination), infant schedule, and neonatal schedule scenarios. Incidence values are calculated over a five-year period, five years after the introduction of vaccination. Each error bar shows the median, 95% CIs over 10 simulation runs.

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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.