To estimate additional acute gastroenteritis (AGE)-related health care encounters and expenditures among children younger than 2 years if routine infant rotavirus vaccination shifts to shared clinical decision-making (SCDM).
Approach:
: This decision-analytic modeling study projected outcomes for an annual US infant birth cohort through age 2 years under scenarios in which 10%, 20%, or 30% of infants shifted from fully vaccinated to unvaccinated. Estimates used current vaccination uptake, AGE-related hospitalization and emergency department (ED) risks, and 2025 direct medical and indirect costs. The model included vaccination’s direct effects but not indirect effects.
Key Findings:
At current uptake, the model estimated more than 20,200 AGE-related hospitalizations and 126,800 AGE-related ED visits by age 2 years per annual US birth cohort. A 10% to 30% shift from fully vaccinated to unvaccinated was projected to add 1,500 to 4,500 hospitalizations and 4,400 to 13,200 ED visits, corresponding to $34.5 million to $103.5 million in additional societal expenditures.
Interpretation:
The authors’ model projected that reduced rotavirus vaccination uptake under SCDM could increase AGE-related morbidity and clinical and economic burdens. Estimates apply to one annual birth cohort and are additive across subsequent cohorts.
Limitations:
The model did not incorporate indirect protection from vaccination. The authors characterize the projected additional AGE-related hospitalizations and ED encounters as minimum estimates associated with changing from a routine recommendation to SCDM.
This peer-reviewed case series examines LYRM7-associated mitochondrial complex III (CIII) deficiency, a rare and typically neurodegenerative mitochondrial disorder, expanding its known phenotypic spectrum through two newly described cases and a literature review.
