ABSTRACT

Introduction

Rotavirus infection causes a significant proportion of diarrhea disease burden in children <5 years of age in Asia and the Pacific regions. The World Health Organization recommends that rotavirus vaccination should be included in national immunization programs to prevent rotavirus gastroenteritis (RVGE).

Areas covered

A literature review was performed to identify and summarize published evidence on RVGE epidemiology and status of rotavirus vaccine use, including the impact and cost-effectiveness of rotavirus vaccination programs in Asia and the Pacific regions (49 countries) during the period 2000–2018.

Expert opinion

Rotavirus vaccination programs have successfully reduced the burden of RVGE in many countries. However, such programs still do not exist in most Asia-Pacific countries, and therefore the burden of RVGE remains high in children <5 years of age. Challenges to vaccine implementation include a lack of surveillance data; safety concerns around intussusception; a general lack of awareness about RVGE disease epidemiology and vaccines among physicians, policy-makers, and parents; insufficient cost-effectiveness analyses; and potential issues with vaccine affordability including vaccination costs and lack of political will. Recommendations to overcome these challenges include developing cost-effectiveness analyses for more diverse national and regional settings, providing non-governmental support for low-income countries, and improving advocacy efforts.

中文翻译：

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亚洲及太平洋地区轮状病毒疫苗使用回顾：挑战和未来前景

摘要

介绍

在亚洲和太平洋地区，轮状病毒感染在 5 岁以下儿童的腹泻病负担中占很大比例。世界卫生组织建议将轮状病毒疫苗接种纳入国家免疫计划，以预防轮状病毒胃肠炎（RVGE）。

涵盖的领域

进行了文献回顾，以确定和总结已发表的关于 RVGE 流行病学和轮状病毒疫苗使用状况的证据，包括 2000-2018 年期间亚洲及太平洋地区（49 个国家）轮状病毒疫苗接种计划的影响和成本效益。

专家意见

在许多国家，轮状病毒疫苗接种计划已成功减轻了 RVGE 的负担。然而，大多数亚太国家仍然不存在此类计划，因此 RVGE 的负担在 5 岁以下儿童中仍然很高。疫苗实施面临的挑战包括缺乏监测数据；肠套叠的安全问题；医生、决策者和家长普遍缺乏对 RVGE 疾病流行病学和疫苗的认识；成本效益分析不足；疫苗可负担性的潜在问题，包括疫苗接种成本和缺乏政治意愿。克服这些挑战的建议包括为更多样化的国家和地区环境进行成本效益分析，为低收入国家提供非政府支持，以及改进宣传工作。