Table 3.
Potential benefits and risks of alternative rotavirus vaccination schedule options in 135 low-income and middle-income countries
| Doses | Rotavirus gastroenteritis deaths | Intussusception deaths | Summary indicators | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total doses (millions)* | Fully vaccinated infants (millions) | n | Number averted (vs no vaccine) | Number averted (vs age-restricted) | n | Excess number (vs no vaccine) | Excess number (vs age-restricted) | Reduction in rotavirus gastroenteritis deaths (%) | Doses per rotavirus gastroenteritis death averted | Number of fully vaccinated infants per excess intussusception case | Rotavirus gastroenteritis deaths averted per excess intussusception death (95% uncertainty interval) | Incremental rotavirus gastroenteritis deaths averted per excess intussusception death vs agerestricted (95% uncertainty interval) | |
| No vaccine | 0 | 0 | 194 471 | ·· | ·· | 14 478 | ·· | ·· | ·· | ·· | ·· | ·· | ·· |
| Age-restricted (primary dose schedules) | |||||||||||||
| BCG | 109 | 103 | 158 527 | 35 945 | ·· | 14 505 | 27 | ·· | 18·5% | 3032 | 643 556 | 1325 (540–3266) | ·· |
| DTP1 | 90 | 86 | 160 292 | 34 179 | ·· | 14 549 | 71 | ·· | 17·6% | 2646 | 133 349 | 481 (196–1163) | ·· |
| BCG plus DTP1 | 217 | 103 | 133 584 | 60 887 | ·· | 14 530 | 53 | ·· | 31·3% | 3564 | 220 468 | 1157 (474–3306) | ·· |
| BCG plus DTP2 | 214 | 100 | 131 626 | 62 845 | ·· | 14 562 | 85 | ·· | 32·3% | 3404 | 117 145 | 743 (312–2186) | ·· |
| BCG plus DTP3 | 196 | 83 | 134 629 | 59 842 | ·· | 14 569 | 91 | ·· | 30·8% | 3276 | 91 528 | 655 (288–1774) | ·· |
| DTP1 plus DTP2† | 180 | 86 | 136 941 | 57 531 | ·· | 14 600 | 122 | ·· | 29·6% | 3142 | 75 069 | 471 (201–1242) | ·· |
| DTP1 plus DTP3 | 170 | 76 | 138 001 | 56 470 | ·· | 14 612 | 134 | ·· | 29·0% | 3020 | 59 745 | 421 (184–1089) | ·· |
| BCG plus DTP1 plus DTP2 | 322 | 100 | 127 733 | 66 739 | ·· | 14 530 | 53 | ·· | 34·3% | 4822 | 214 021 | 1269 (542–3316) | ·· |
| BCG plus DTP1 plus DTP3 | 304 | 83 | 125 308 | 69 164 | ·· | 14 530 | 53 | ·· | 35·6% | 4394 | 177 465 | 1315 (560–3436) | ·· |
| BCG plus DTP2 plus DTP3 | 300 | 83 | 126 718 | 67 753 | ·· | 14 562 | 85 | ·· | 34·8% | 4441 | 97 152 | 801 (333–2336) | ·· |
| DTP1 plus DTP2 plus DTP3† | 260 | 76 | 131 986 | 62 485 | ·· | 14 600 | 122 | ·· | 32·1% | 4173 | 66 530 | 512 (218–1338) | ·· |
| Age-unrestricted (primary dose schedules) | |||||||||||||
| BCG | 114 | 108 | 156 279 | 38 192 | 2247 | 14 524 | 46 | 19 | 19·6% | 2993 | 373 252 | 828 (346–1977) | 118 (56–246) |
| DTP1 | 117 | 111 | 153 245 | 41 227 | 7048 | 14 618 | 140 | 69 | 21·2% | 2842 | 71 459 | 294 (125–684) | 102 (48–217) |
| BCG plus DTP1 | 227 | 107 | 130 147 | 64 324 | 3438 | 14 546 | 68 | 16 | 33·1% | 3532 | 186 572 | 940 (394–2474) | 218 (108–476) |
| BCG plus DTP2 | 225 | 105 | 128 034 | 66 438 | 3592 | 14 583 | 106 | 21 | 34·2% | 3393 | 104 475 | 630 (265–1733) | 172 (84–363) |
| BCG plus DTP3 | 223 | 103 | 128 592 | 65 879 | 6037 | 14 596 | 119 | 27 | 33·9% | 3387 | 89 036 | 555 (241–1443) | 221 (105–469) |
| DTP1 plus DTP2† | 230 | 107 | 126 649 | 67 823 | 10 292 | 14 679 | 201 | 79 | 34·9% | 3400 | 47 707 | 338 (145–831) | 131 (61–280) |
| DTP1 plus DTP3 | 226 | 104 | 127 011 | 67 460 | 10 990 | 14 691 | 213 | 79 | 34·7% | 3365 | 43 032 | 316 (137–768) | 139 (65–292) |
| BCG plus DTP1 plus DTP2 | 338 | 105 | 123 843 | 70 628 | 3890 | 14 545 | 67 | 15 | 36·3% | 4788 | 187 788 | 1049 (455–2544) | 264 (122–576) |
| BCG plus DTP1 plus DTP3 | 335 | 103 | 120 044 | 74 428 | 5264 | 14 546 | 68 | 16 | 38·3% | 4512 | 180 330 | 1092 (453–2722) | 338 (158–724) |
| BCG plus DTP2 plus DTP3 | 334 | 103 | 121 869 | 72 603 | 4850 | 14 583 | 105 | 21 | 37·3% | 4601 | 102 349 | 689 (291–1881) | 234 (115–490) |
| DTP1 plus DTP2 plus DTP3† | 339 | 104 | 120 323 | 74 148 | 11 663 | 14 678 | 201 | 79 | 38·1% | 4590 | 46 222 | 369 (160–895) | 148 (69–317) |
| Age-unrestricted (booster dose schedules) | |||||||||||||
| BCG plus Meas1 | 222 | 102 | 135 675 | 58 796 | ·· | 14 563 | 85 | ·· | 30·2% | 3783 | 122 994 | 689 (293–1592) | ·· |
| DTP1 plus Meas1 | 225 | 103 | 133 285 | 61 187 | ·· | 14 656 | 179 | ·· | 31·5% | 3691 | 49 466 | 343 (146–797) | ·· |
| BCG plus DTP1 plus Meas1 | 335 | 102 | 117 652 | 76 819 | ·· | 14 546 | 68 | ·· | 39·5% | 4360 | 178 757 | 1125 (466–2937) | ·· |
| BCG plus DTP2 plus Meas1 | 332 | 102 | 116 970 | 77 501 | ·· | 14 583 | 105 | ·· | 39·9% | 4294 | 101 289 | 735 (306–2024) | ·· |
| BCG plus DTP3 plus Meas1 | 329 | 101 | 119 377 | 75 094 | ·· | 14 596 | 118 | ·· | 38·6% | 4389 | 87 531 | 634 (271–1649) | ·· |
| DTP1 plus DTP2 plus Meas1 | 338 | 103 | 115 528 | 78 944 | ·· | 14 678 | 201 | ·· | 40·6% | 4292 | 45 610 | 393 (168–974) | ·· |
| DTP1 plus DTP3 plus Meas1 | 333 | 102 | 117 757 | 76 714 | ·· | 14 691 | 213 | ·· | 39·4% | 4358 | 42 111 | 360 (155–871) | ·· |
DTP=diphtheria–tetanus–pertussis. Meas=measles vaccine. Numbers are the totals expected in all 135 low-income and middle-income countries if all countries used the same schedule.
*
Assumes 5% wastage for all doses.
†
Current schedule options recommended by WHO; other options should be interpreted with caution until more evidence is established on their safety and efficacy.