title: Dynamic modeling of cost-effectiveness of rotavirus vaccination, Kazakhstan.
abstract: The government of Kazakhstan, a middle-income country in Central Asia, is considering the introduction of rotavirus vaccination into its national immunization program. We performed a cost-effectiveness analysis of rotavirus vaccination spanning 20 years by using a synthesis of dynamic transmission models accounting for herd protection. We found that a vaccination program with 90% coverage would prevent ≈880 rotavirus deaths and save an average of 54,784 life-years for children <5 years of age. Indirect protection accounted for 40% and 60% reduction in severe and mild rotavirus gastroenteritis, respectively. Cost per life year gained was US $18,044 from a societal perspective and US $23,892 from a health care perspective. Comparing the 2 key parameters of cost-effectiveness, mortality rates and vaccine cost at <US $2.78 per dose, vaccination program costs would be entirely offset. To further evaluate efficacy of a vaccine program, benefits of indirect protection conferred by vaccination warrant further study.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Freiesleben de Blasio
authors.forename: Elmira
authors.initials: E
authors.lastname: Flem
authors.forename: Renat
authors.initials: R
authors.lastname: Latipov
authors.forename: Ajnagul
authors.initials: A
authors.lastname: Kuatbaeva
authors.forename: Ivar Sønbø
authors.initials: IS
authors.lastname: Kristiansen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006801:Humans; D017589:Immunization Programs / Q000191:economics; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007623:Kazakhstan / Q000453:epidemiology; D008875:Middle Aged; D012401:Rotavirus / Q000276:immunology*; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000191:economics* / Q000276:immunology*; D014611:Vaccination / Q000191:economics*; D055815:Young Adult
chemical_list: D022243:Rotavirus Vaccines
keywords: Kazakhstan; break-even price; cost-effectiveness; dynamic modeling; herd immunity; rotavirus; vaccination; vaccine; viruses