Who’s at Risk?

Our analysis of rotavirus.

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Manufacturer’s Inserts and efficacy statements:

RotaTeq (live virus)– (from section 14.5 in package insert)
             for serotype G1P1a[8]- 74.9%.
             for serotype G2P1[4]- 63.4%

Cost-effectiveness Analysis of a Rotavirus Immunization Program for the United States in the Journal of American Medical Association (JAMA) was published in 1998 discussing the merits of implementing the rotavirus vaccine into the current immunization program.

Context.— Rotavirus is the most common cause of severe diarrhea in children, and a live, oral vaccine may soon be licensed for prevention.

Results.— A routine, universal rotavirus immunization program would prevent 1.08 million cases of diarrhea, avoiding 34000 hospitalizations, 95000 emergency department visits, and 227000 physician visits in the first 5 years of life. At $20 per dose, the program would cost $289 million and realize a net loss of $107 million to the health care system—$103 per case prevented. The program would provide a net savings of $296 million to society. Threshold analysis identified a break-even price per dose of $9 for the health care system and $51 for the societal perspective. Greater disease burden and greater vaccine efficacy and lower vaccine price increased cost-effectiveness.

Additionally, the CDC themselves seem to believe that acute gastroenteritis can be cared for with proper at-home treatment:

Home Management of Acute Diarrhea

Treatment with ORS is simple and enables management of uncomplicated cases of diarrhea at home, regardless of etiologic agent. As long as caregivers are instructed properly regarding signs of dehydration or are able to determine when children appear markedly ill or appear not to be responding to treatment, therapy should begin at home. Early intervention can reduce such complications as dehydration and malnutrition. Early administration of ORS leads to fewer office, clinic, and emergency department (ED) visits (37) and to potentially fewer hospitalizations and deaths.

*ORS being oral rehydration solutions such as pedialyte.  Breastfed infants should continue nursing on demand.

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