The ROTA Council convened representatives* from countries across Asia and beyond at the 5th Asian Vaccine Conference in Hanoi, Vietnam on June 14, 2015 to discuss challenges to rotavirus vaccine introduction in their respective countries, lessons learned from the Philippines—which has introduced rotavirus vaccines regionally—and ways to accelerate the introduction of rotavirus vaccines across Asia.
This meeting was important because despite evidence of significant disease burden, no country in Asia has yet introduced rotavirus vaccines into its national immunization program. The Philippines has introduced at a regional level and Thailand has a pilot program.
Key takeaways of the session include:
- Advocacy is needed to raise awareness of the burden of rotavirus disease and the benefits of rotavirus vaccines among providers, parents and policymakers.
Experience from the Philippines demonstrated that sustained advocacy efforts are essential for successful introduction and implementation of rotavirus vaccines. ROTAPHIL (Rotavirus Organization for Training and Advocacy in the Philippines), a group of pediatric infectious disease, gastrointestinal and vaccine experts who came together to advocate for rotavirus vaccines, used tactics such as:
- Press conferences with CDC experts and legislators
- A position paper targeting the senate committee on health
- Dissemination of key messages such as: “Rotavirus disease should be recognised as one of the highest public health priorities by governments, health administrators and medical community decision makers in Asia. The consensus of the experts at this scientific meeting was that universal vaccination programs to address rotavirus disease should be implemented.”
- Proactive media engagement
- Doctors are trusted messengers for parents and policymakers, so it is important that providers (doctors and nurses) understand the value of rotavirus vaccines and advocate for them.
Several participants spoke to the importance of involving pediatric associations in advocacy, and how instrumental the voice of healthcare providers has been in the uptake or rotavirus vaccines, the introduction of other vaccines and implementation of various child health interventions.
- Government endorsement is important, especially in countries with high confidence in government.
Currently rotavirus vaccines are available in several countries in Asia in the private market. Parents can choose to pay to have their children vaccinated, but some question the importance of rotavirus vaccines because they are not recommended by health officials. Inclusion of the vaccine in the national immunization program is a form of endorsement, and even publically taking steps in that direction may increase vaccination rates in the meantime.
- More research is needed to understand the full cost of rotavirus disease and the full cost-savings of vaccination.
As noted in the ROTA Council pre-congress workshop, “Emerging Rotavirus Vaccines in Asia,” the decline in rotavirus mortality means it is increasingly important to communicate the impact of rotavirus morbidity. Costs include direct care such as hospital visits, outpatient visits and transportation to medical facilities, as well as parents’ missed work and lost wages. Additionally, hospital beds are filled with children being treated for rotavirus diarrhea, which means beds are not available to treat children suffering from other illnesses. Overcrowded hospital wards promote cross infection and lengthen hospital stays. Additional research is needed to fully quantify the costs of rotavirus, and the benefits of implementing the vaccine on a national scale.
- Vaccine pricing remains a barrier, and more consistent or transparent pricing mechanisms are needed.
Decision makers need accurate information on rotavirus vaccine pricing to develop appropriate plans for the vaccine to be added into their current immunization program. Unfortunately, lack of transparency around true vaccine pricing, or lack of mechanisms to negotiate price prior to tendering, causes countries to use the private sector price in economic evaluation, leading to the possibly inaccurate conclusion that the vaccine price is too high. For more detail, please see the past work of ROTA Council member Tony Nelson here and here.
For advocacy resources, visit the ROTA Council’s advocacy toolkit.
* Participants included representatives from the following countries: