title: A cost effectiveness and capacity analysis for the introduction of universal rotavirus vaccination in Kenya: comparison between Rotarix and RotaTeq vaccines.
abstract: BACKGROUND
  Diarrhoea is an important cause of death in the developing world, and rotavirus is the single most important cause of diarrhoea associated mortality. Two vaccines (Rotarix and RotaTeq) are available to prevent rotavirus disease. This analysis was undertaken to aid the decision in Kenya as to which vaccine to choose when introducing rotavirus vaccination.
  
  
  METHODS
  Cost-effectiveness modelling, using national and sentinel surveillance data, and an impact assessment on the cold chain.
  
  
  RESULTS
  The median estimated incidence of rotavirus disease in Kenya was 3015 outpatient visits, 279 hospitalisations and 65 deaths per 100,000 children under five years of age per year. Cumulated over the first five years of life vaccination was predicted to prevent 34% of the outpatient visits, 31% of the hospitalizations and 42% of the deaths. The estimated prevented costs accumulated over five years totalled US$1,782,761 (direct and indirect costs) with an associated 48,585 DALYs. From a societal perspective Rotarix had a cost-effectiveness ratio of US$142 per DALY (US$5 for the full course of two doses) and RotaTeq US$288 per DALY ($10.5 for the full course of three doses). RotaTeq will have a bigger impact on the cold chain compared to Rotarix.
  
  
  CONCLUSIONS
  Vaccination against rotavirus disease is cost-effective for Kenya irrespective of the vaccine. Of the two vaccines Rotarix was the preferred choice due to a better cost-effectiveness ratio, the presence of a vaccine vial monitor, the requirement of fewer doses and less storage space, and proven thermo-stability.
authors.affiliation: Immunisation, Hepatitis and Blood Safety Department, Health Protection Agency, London, United Kingdom.
authors.forename: Albert Jan
authors.initials: AJ
authors.lastname: van Hoek
authors.forename: Mwanajuma
authors.initials: M
authors.lastname: Ngama
authors.forename: Amina
authors.initials: A
authors.lastname: Ismail
authors.forename: Jane
authors.initials: J
authors.lastname: Chuma
authors.forename: Samuel
authors.initials: S
authors.lastname: Cheburet
authors.forename: David
authors.initials: D
authors.lastname: Mutonga
authors.forename: Tatu
authors.initials: T
authors.lastname: Kamau
authors.forename: D James
authors.initials: DJ
authors.lastname: Nokes
mesh_terms: D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D012401:Rotavirus / Q000276:immunology*; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D014765:Viral Vaccines / Q000008:administration & dosage*
chemical_list: D014765:Viral Vaccines