Rotavirus Vaccination of Infants Delayed and Limited within the National Immunization Programme in the Netherlands: An Opportunity Lost

In this study, we estimated the benefits of rotavirus vaccination for infants had the rotavirus vaccine been introduced in the Netherlands as of its market authorization in 2006. An age-structured, deterministic cohort model was developed to simulate different birth cohorts over a period of 15 years from 2006 until 2021, comparing both universal and targeted high-risk group vaccination to no vaccination. Different scenarios for the duration of protection (5 or 7 years) and herd immunity (only for universal vaccination) were analyzed. All birth cohorts together included 2.6 million infants, of which 7.9% were high-risk individuals, and an additional 13.2 million children between 1–15 years born prior to the first cohort in 2006. The costs and health outcomes associated with rotavirus vaccination were calculated per model scenario and discounted at 4% and 1.5%, respectively. Our analysis reveals that, had rotavirus vaccination been implemented in 2006, it would have prevented 356,800 (51% decrease) and 32,200 (5% decrease) cases of rotavirus gastroenteritis after universal and targeted vaccination, respectively. Over the last 15 years, this would have led to significant avoided costs and quality-adjusted life year losses for either vaccination strategy with the most favorable outcomes for universal vaccination. Clearly, an opportunity has been lost.

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Targeted rotavirus vaccination of high-risk infants; a low cost and highly cost-effective alternative to universal vaccination

BMC Medicine ◽

10.1186/1741-7015-11-112 ◽

2013 ◽

Vol 11 (1) ◽

Cited By ~ 28

Author(s):

Patricia Bruijning-Verhagen ◽

Marie-Josée J Mangen ◽

Mariet Felderhof ◽

Nico G Hartwig ◽

Marlies van Houten ◽

...

Keyword(s):

High Risk ◽

Low Cost ◽

Cost Effective ◽

Universal Vaccination ◽

Effective Alternative ◽

Rotavirus Vaccination ◽

Cost Effective Alternative ◽

High Risk Infants

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Seroprevalence of SARS-CoV-2 Antibodies in Symptomatic Individuals Is Higher than in Persons Who Are at Increased Risk Exposure: The Results of the Single-Center, Prospective, Cross-Sectional Study

Vaccines ◽

10.3390/vaccines9060627 ◽

2021 ◽

Vol 9 (6) ◽

pp. 627

Author(s):

Alexandr Zurochka ◽

Maria Dobrinina ◽

Vladimir Zurochka ◽

Desheng Hu ◽

Alexandr Solovyev ◽

...

Keyword(s):

High Risk ◽

Risk Group ◽

Herd Immunity ◽

Cross Sectional Study ◽

High Risk Group ◽

Enzyme Linked Immunosorbent Assay ◽

Cross Sectional ◽

Seropositivity Rate ◽

Symptomatic Group ◽

Increased Risk

The present study aimed to assess antibody seropositivity prevalence among symptomatic individuals and individuals with a high risk of occupational exposure to SARS-CoV-2. Participants from Chelyabinsk (Russian Federation) who were at an increased risk of exposure to SARS-CoV-2 (high-risk group, n = 1091) and participants who either had symptoms consistent with COVID-19 or were suspected to have experienced COVID-19 in the past (symptomatic group, n = 692) were enrolled between 28 September and 30 December 2020. Blood samples were tested by enzyme-linked immunosorbent assay D-5501 SARS-Cov-2-IgG-EIA-BEST and D-5502 SARS-Cov-2-IgM-EIA-BEST (AO Vector-Best, Novosibirsk, Russia). The overall seropositivity rate was 28.33–28.53%. SARS-CoV-2 antibodies were detected in 17.23% (adjusted prevalence of 17.17–17.29%) of participants in the high-risk and 45.95% (adjusted prevalence of 45.91–46.24%) in the symptomatic group. Higher IgG and IgM titers were observed in women compared to men, as well as in participants in the symptomatic group compared to those in the high-risk group. The results indicate that the seroprevalence among residents in several Russian regions is low (28.38%) and inadequate to provide herd immunity. The lower seroprevalence among participants in the high-risk group may be attributed to the enforcement of healthcare protocols and the use of adequate personal protective equipment.

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Optimal vaccine strategy to control COVID-19 pandemic in middle-income countries: Modelling case study of Thailand

10.21203/rs.3.rs-270635/v1 ◽

2021 ◽

Author(s):

Nantasit Luangasanatip ◽

Wirichada Pan-Ngum ◽

Juthamas Prawjaeng ◽

Sompob Saralamba ◽

Lisa White ◽

...

Keyword(s):

High Risk ◽

Risk Group ◽

Vaccination Strategy ◽

High Risk Group ◽

Vaccine Strategy ◽

Short Term ◽

Middle Income ◽

Incidence Group ◽

High Incidence ◽

The Right

Abstract Thailand is facing the dilemma of which groups to prioritise for the limited first tranche of vaccinations in 2021. A mathematical modelling analysis was performed to compare the potential short-term impact of allocating the available doses to either the high-risk group (over 65-year-olds) or the high incidence group (aged 20-39). Vaccinating the high incidence group with a vaccine with sufficiently high protection against infection (more than 50%) could provide enough herd effects to delay the expected epidemic peak, resulting in fewer deaths within the 12-month time horizon compared to vaccinating the same number of the high-risk group. After 12 months, if no further vaccination or other interventions were deployed, this strategy would lead to more deaths. With the right vaccine efficacy profile, targeting the high incidence groups could be a viable short-term component of the Thai vaccination strategy. These results and emerging evidence on vaccines and susceptibility suggest prioritisation guidelines should be more nuanced.

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An analysis of the potential global impact of dosing regimen and rollout options for the ChAdOx1 nCoV-19 vaccine

10.21203/rs.3.rs-296726/v1 ◽

2021 ◽

Author(s):

Ricardo Aguas ◽

Anouska Bharath ◽

Lisa White ◽

Bo Gao ◽

Merryn Voysey ◽

...

Keyword(s):

High Risk ◽

Low Income ◽

Vaccine Efficacy ◽

Socioeconomic Development ◽

Optimal Allocation ◽

Vaccination Strategy ◽

Risk Groups ◽

High Risk Group ◽

Low Income Countries ◽

Time Interval

Abstract Background The ongoing COVID-19 pandemic has placed an unprecedented health and economic burden on countries at all levels of socioeconomic development, emphasizing the need to evaluate the most effective vaccination strategy in multiple, diverse environments. The high reported efficacy, low cost, and long shelf-life of the ChAdOx1 nCoV-19 vaccine positions it well for evaluation in different settings. Methods Using data from the ongoing ChAdOx1 nCoV-19 clinical trials, an individual-based model was constructed to predict the 6-month population-level impact of vaccine deployment. A detailed probabilistic sensitivity analysis (PSA) was developed to evaluate the importance of epidemiological, demographic, immunological, and logistical factors in determining vaccine effectiveness. Using representative countries, logistical plans for vaccination rollout at various levels of vaccine availability and delivery speed, conditional on vaccine efficacy profiles (efficacy of the booster dose, time interval between doses, and relative efficacy of the first dose) were explored.Findings and Interpretation Our results highlight how expedient vaccine delivery to high-risk groups is critical in mitigating COVID-19 disease and mortality. In scenarios where the number of vaccine doses available is insufficient for high-risk groups (those aged more than 65 years) to receive two vaccine doses, administration of a single dose of vaccine is optimal. This effect is consistent even when vaccine efficacy after one dose is just 75% of the levels achieved after two doses. These findings offer a nuanced perspective of the critical drivers of COVID-19 vaccination effectiveness and can inform optimal allocation strategies. These are relevant to high-income countries with a large high-risk group population as well as to low-income countries with younger populations, where the cost and logistical challenges of procuring and delivering two doses for each citizen represent a significant challenge.

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A model-based evaluation of the national immunization programme against rubella infection and congenital rubella syndrome in The Netherlands

Epidemiology and Infection ◽

10.1017/s0950268898001472 ◽

1998 ◽

Vol 121 (3) ◽

pp. 653-671 ◽

Cited By ~ 10

Author(s):

O. G. van der HEIJDEN ◽

M. A. E. CONYN-van SPAENDONCK ◽

A. D. PLANTINGA ◽

M. E. E. KRETZSCHMAR

Keyword(s):

The Netherlands ◽

Model Simulation ◽

Vaccination Strategy ◽

Congenital Rubella Syndrome ◽

Childbearing Age ◽

Rubella Infection ◽

Immunization Programme ◽

Congenital Rubella ◽

National Immunization Programme ◽

Notification Data

In order to improve the prevention of cases of congenital rubella syndrome in The Netherlands, in 1987 the selective vaccination strategy against rubella infection in girls was replaced by mass vaccination. This decision was supported by mathematical model analyses carried out by Van Druten and De Boo. In order to compare the predicted impact of the rubella vaccination programme with the current available data in more detail, a similar model was built. Although the model predicts elimination of the rubella virus, data show that virus circulation is still present at a higher level than expected by the model. Simulation studies indicate that import of infection and a lower vaccine effectiveness, related to possible asymptomatic reinfection of vaccinated people, could be sources contributing to the present virus circulation. Even though the number of infections is much higher than the number of reported cases of disease, limited serosurveillance data and case notification data show that females of childbearing age are well protected by immunization.

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Road injuries, health burden, but not fatalities make 12- to 17-year olds a high risk group in the Netherlands

European Journal of Public Health ◽

10.1093/eurpub/ckx045 ◽

2017 ◽

Vol 27 (6) ◽

pp. 981-984 ◽

Cited By ~ 2

Author(s):

Divera A.M. Twisk ◽

Niels M. Bos ◽

Wendy A.M. Weijermars

Keyword(s):

High Risk ◽

The Netherlands ◽

Risk Group ◽

High Risk Group ◽

Health Burden

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Outcome of carotid endarterectomy under local anaesthesia with respect to the patients’ risk profile

VASA ◽

10.1024/0301-1526.38.3.225 ◽

2009 ◽

Vol 38 (3) ◽

pp. 225-233 ◽

Cited By ~ 2

Author(s):

Aleksic ◽

Luebke ◽

Brunkwall

Keyword(s):

Myocardial Infarction ◽

High Risk ◽

Carotid Endarterectomy ◽

Complication Rate ◽

Local Anaesthesia ◽

High Risk Group ◽

High Risk Patients ◽

Hostile Neck ◽

Risk Patients ◽

Angioplasty And Stenting

Background: In the present study the perioperative complication rate is compared between high- and low-risk patients when carotid endarterectomy (CEA) is routinely performed under local anaesthesia (LA). Patients and methods: From January 2000 through June 2008 1220 consecutive patients underwent CEA under LA. High-risk patients fulfilled at least one of the following characteristics: ASA 4 classification, “hostile neck”, recurrent ICA stenosis, contralateral ICA occlusion, age ≥ 80 years. The combined complication rate comprised any new neurological deficit (TIA or stroke), myocardial infarction or death within 30 days after CEA, which was compared between patient groups. Results: Overall 309 patients (25%) were attributed to the high-risk group, which differed significantly regarding sex distribution (more males: 70% vs. 63%, p = 0,011), neurological presentation (more asymptomatic: 72% vs. 62%, p = 0,001) and shunt necessity (33% vs. 14%, p < 0,001). In 32 patients 17 TIAs and 15 strokes were observed. In 3 patients a myocardial infarction occurred. Death occurred in one patient following a stroke and in another patient following myocardial infarction, leading to a combined complication rate of 2,9% (35/1220). In the multivariate analysis only previous neurological symptomatology (OR 2,85, 95% CI 1,38-5,91) and intraoperative shunting (OR 5,57, 95% CI 2,69-11,55) were identified as independent risk factors for an increased combined complication rate. Conclusions: With the routine use of LA, CEA was not associated with worse outcome in high-risk patients. Considering the data reported in the literature, it does not appear justified to refer high-risk patients principally to carotid angioplasty and stenting (CAS) when LA can be chosen to perform CEA.

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Quality management in the prophylaxis of venous thrombembolism - Results of a survey including 464 medical and surgical patients

VASA ◽

10.1024/0301-1526/a000082 ◽

2011 ◽

Vol 40 (2) ◽

pp. 123-130

Author(s):

Klein-Weigel ◽

Richter ◽

Arendt ◽

Gerdsen ◽

Härtwig ◽

...

Keyword(s):

Renal Function ◽

High Risk ◽

Quality Management ◽

High Risk Group ◽

Surgical Patients ◽

Medical Patients ◽

Risk Status ◽

Vte Prophylaxis ◽

Safety Concerns

Background: We surveyed the quality of risk stratification politics and monitored the rate of entries to our company-wide protocol for venous thrombembolism (VTE) prophylaxis in order to identify safety concerns. Patients and methods: Audit in 464 medical and surgical patients to evaluate quality of VTE prophylaxis. Results: Patients were classified as low 146 (31 %), medium 101 (22 %), and high risk cases 217 (47 %). Of these 262 (56.5 %) were treated according to their risk status and in accordance with our protocol, while 9 more patients were treated according to their risk status but off-protocol. Overtreatment was identified in 73 (15.7 %), undertreatment in 120 (25,9 %) of all patients. The rate of incorrect prophylaxis was significantly different between the risk categories, with more patients of the high-risk group receiving inadequate medical prophylaxis (data not shown; p = 0.038). Renal function was analyzed in 392 (84.5 %) patients. In those patients with known renal function 26 (6.6 %) received improper medical prophylaxis. If cases were added in whom prophylaxis was started without previous creatinine control, renal function was not correctly taken into account in 49 (10.6 %) of all patients. Moreover, deterioration of renal function was not excluded within one week in 78 patients (16.8 %) and blood count was not re-checked in 45 (9.7 %) of all patients after one week. There were more overtreatments in surgical (n = 53/278) and more undertreatments in medical patients (n = 54/186) (p = 0.04). Surgeons neglected renal function and blood controls significantly more often than medical doctors (p-values for both < 0.05). Conclusions: We found a low adherence with our protocol and substantial over- and undertreatment in VTE prophylaxis. Besides, we identified disregarding of renal function and safety laboratory examinations as additional safety concerns. To identify safety problems associated with medical VTE prophylaxis and hot spots quality management-audits proved to be valuable instruments.

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