Overcoming perceptions of financial barriers to rotavirus vaccine introduction in Asia

E. Anthony S. Nelson, Ciro A. De Quadros, Mathuram Santosham, Umesh D. Parashar, Duncan Steele

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Despite a WHO recommendation in 2009, reaffirmed in 2013, that all countries should consider introducing rotavirus vaccines into their National Immunization Programs, as of June 2013 only 45 have done so. One major consideration appears to have been the costs of the vaccine to countries. Of concern is that Asian countries have been slow to introduce rotavirus vaccines despite having robust data that could inform the decision-making process. Although decisions on new vaccine introduction are very complex and vary by country and region, economic evaluations are often pivotal once vaccine efficacy and safety has been established, and disease burden documented and communicated. Unfortunately, with private sector list prices of vaccines often used in economic evaluations, rather than a potential public health sector pricing structure, policymakers may defer decisions on rotavirus vaccine introduction based on the belief that "the vaccine price is too high," even though this might be based on erroneous data. The Pan American Health Organization's Revolving Fund provides one example of how vaccine price can be made more competitive and transparent through a regional tendering process. Other mechanisms, such as tiered pricing and UNICEF procurement, also exist that could help Asian and other countries move forward more quickly with rotavirus vaccine introduction.

Original languageEnglish (US)
Pages (from-to)2418-2426
Number of pages9
JournalHuman Vaccines and Immunotherapeutics
Issue number11
StatePublished - Nov 2013


  • Advisory committee
  • Evidence-based decision making
  • Immunization financing
  • Immunization policy
  • National Immunization Technical Advisory Group
  • Policy recommendations
  • Rotavirus vaccine

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pharmacology


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