原创力文档removing the age restrictions for rotavirus vaccination a benefit-risk modeling analysis取消年龄限制为轮状病毒疫苗接种其建模分析.pdfVIP
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removing the age restrictions for rotavirus vaccination a benefit-risk modeling analysis取消年龄限制为轮状病毒疫苗接种其建模分析
Removing the Age Restrictions for Rotavirus Vaccination:
A Benefit-Risk Modeling Analysis
1 2 2 1 1
Manish M. Patel *, Andrew D. Clark , Colin F. B. Sanderson , Jacqueline Tate , Umesh D. Parashar
1 National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America, 2 London School of
Hygiene and Tropical Medicine, London, United Kingdom
Abstract
Background: To minimize potential risk of intussusception, the World Health Organization (WHO) recommended in 2009
that rotavirus immunization should be initiated by age 15 weeks and completed before 32 weeks. These restrictions could
adversely impact vaccination coverage and thereby its health impact, particularly in developing countries where delays in
vaccination often occur.
Methods and Findings: We conducted a modeling study to estimate the number of rotavirus deaths prevented and the
number of intussusception deaths caused by vaccination when administered on the restricted schedule versus an
unrestricted schedule whereby rotavirus vaccine would be administered with DTP vaccine up to age 3 years. Countries were
grouped on the basis of child mortality rates, using WHO data. Inputs were estimates of WHO rotavirus mortality by week of
age from a recent study, intussusception mortality based on a literature review, predicted vaccination rates by week of age
from USAID Demographic and Health Surveys, the United Nations Children’s Fund (UNICEF) Multiple Indicator Cluster
Surveys (MICS), and WHO-UNICEF 2010 country-specific coverage estimates, and published estimates of vaccine efficacy and
vaccine-associated intussusception risk. On the basis o
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