Impact assessment of the incorporation of the rotavirus vaccine in the province of San Luis - Argentina.

Rotavirus (RV) is the main cause of acute gastroenteritis (AGE) in young children. The San Luis province of Argentina introduced RV vaccination in May 2013. We estimate vaccine impact (RVI) using real-world data. Data on all-cause AGE cases and AGE-related hospitalisations for San Luis and the adjacent Mendoza province (control group) were obtained and analysed by interrupted time-series methods. Regardless of the model used for counterfactual predictions, we estimated a reduction in the number of all-cause AGE cases of 20-25% and a reduction in AGE-related hospitalisations of 55-60%. The vaccine impact was similar for each age group considered (<1 year, <2 years and <5 years). RV vaccination was estimated to have reduced direct medical costs in the province by about 4.5 million pesos from May 2013 to December 2014. Similar to previous studies, we found a higher impact of RV vaccination in preventing severe all-cause AGE cases requiring hospitalisation than in preventing all-cases AGE cases presenting for medical care. An assessment of the economic value of RV vaccination could take other benefits into account in addition to the avoided medical costs and the costs of vaccination.

Persistence of immunity and seroprotection 4 years after a primary vaccination schedule with a Hansenula polymorpha recombinant hepatitis B vaccine.

To evaluate the persistence of the immune response in a population of healthy volunteers that had been vaccinated with a new Hansenula polymorpha recombinant hepatitis B vaccine in a previous clinical study 4 years before, we measured the titre of anti-HBs. All, but one of the evaluated volunteers remained protected. None of them had experienced any adverse event related to the vaccine from the moment of immunization, to the present. The vaccine proved to be immunogenic and to confer long-term protection in this group.

A cost-benefit analysis of programmatic use of CVD 103-HgR live oral cholera vaccine in a high-risk population.

BACKGROUND: Cholera spread to Latin America in 1991; subsequently, cholera vaccination was considered as an interim intervention until long-term solutions involving improved water supplies and sanitation could be introduced. Three successive summer cholera outbreaks in northern Argentina and the licensing of the new single-dose oral cholera vaccine, CVD 103-HgR, raised questions of the cost and benefit of using this new vaccine. METHODS: This study explored the potential benefits to the Argentine Ministry of Health of treatment costs averted, versus the costs of vaccination with CVD 103-HgR in the relatively confined population of northern Argentina affected by the cholera outbreaks. Water supplies and sanitation in this area are poor but a credible infrastructure for vaccine delivery exists. RESULTS: In our cost-benefit model of a 3-year period (1992-1994) with an annual incidence of 2.5 case-patients per 1000 population and assumptions of vaccine efficacy of 75% and coverage of 75%, vaccination of targeted high risk groups would prevent 1265 cases. CONCLUSION: Assuming a cost of US$602 per treated case and of US$1.50 per dose of vaccine, the total discounted savings from use of vaccine in the targeted groups would be US$132,100. The projected savings would be altered less by vaccine coverage (range 75-90%) or efficacy (60-85%) changes than by disease incidence changes. Our analysis underestimated the true costs of cholera in Argentina because we included only medical expenditures; Indirect losses to trade and tourism had the greatest economic impact. However, vaccination with CVD 103-HgR was still cost-beneficial in the base case.

Health advice for travelers to Latin America.

Practical and precise information about the potential infectious health hazards that travelers to Latin America may encounter is reviewed in this article. Some diseases are briefly described, others are only mentioned. The countries have been grouped into four geographical areas following the classification of the World Health Organization. The discussion on each area includes information on travelers' diarrhea, malaria, cholera, typhoid fever, yellow fever, and other diseases or special problems.