A new economic evaluation from Syria assesses whether universal infant rotavirus vaccination would be a good use of scarce health resources in a protracted crisis setting. Using a decision tree model, the authors simulate a 2023 birth cohort of 573,944 children over five years, comparing a two-dose Rotarix® schedule with no vaccination from the government payer perspective. They draw on local data for rotavirus-attributable severe gastroenteritis (accounting for 27% of severe GE in Syrian children), health service use, and treatment costs, complemented by published literature and international databases. Key outcomes include cases, outpatient visits and hospitalizations averted, as well as deaths and disability-adjusted life years (DALYs) prevented.
The model suggests that introducing a two-dose rotavirus vaccine schedule would avert around 77,500 rotavirus gastroenteritis cases over five years, cut outpatient visits by 59%, and reduce severe hospitalizations by 41%. The program’s incremental cost to the health system is estimated at about US$3.24 million, with an incremental cost of roughly US$2,098 per DALY averted—well below the “three times GDP per capita” threshold commonly used in WHO guidance for very cost-effective interventions in low-income settings. The authors conclude that rotavirus vaccination in Syria would substantially reduce the health-care burden and prevent avoidable child deaths, while offering strong value for money, and they call on policy-makers and partners to prioritize its inclusion in the national immunization program with sustainable, equity-focused financing arrangements.
Thumbnail image credit: Gavi / 2015
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