Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis

Abstract

Introduction Rotavirus remains the leading cause of severe diarrhea in children under 5 years worldwide. In the US, Rotarix® (RV1) and RotaTeq® (RV5), have been associated with reductions in and severity of rotavirus disease. Studies have evaluated the impact of RV1 or RV5 but little is known about the impact of incomplete or mixed vaccination upon vaccine effectiveness. Methods Case control study to examine association of combined RV1 and RV5 and rotavirus acute gastroenteritis, factoring severity of diarrheal disease. Children born after March 1, 2009 with acute gastroenteritis from three pediatric hospitals in Atlanta, Georgia were approached for enrollment. Survey was administered, stool specimen was collected, and vaccination records were obtained. Results 891 of 1127 children with acute gastroenteritis were enrolled. Stool specimens were collected from 708 for rotavirus testing; 215 stool samples tested positively for rotavirus. Children >12 months of age were more likely to have rotavirus. Children categorized with Vesikari score of >11 were almost twice as likely to be rotavirus positive. Prior rotavirus vaccination decreased the mean Vesikari score, p < 0.0001. Children with complete single type vaccination were protected against rotavirus (OR 0.21, 95% CI: 0.14–0.31, p < 0.0001). Conclusion Complete rotavirus vaccination with a single vaccine type resulted in protection against rotavirus diarrhea and decrease in severity of rotavirus gastroenteritis. Incomplete rotavirus vaccination either with a single vaccine or mixed vaccination types also provided some protection.

Community-level interventions for mitigating the risk of waterborne diarrheal diseases: a systematic review

“…In the USA, combined vaccine effectiveness for full RV1 and RV5 vaccines was 80% in children younger than 8 years old [ 68 ]. In the USA, Mohammed et al [ 69 ] showed that children were still protected if they received combined vaccines (single vaccine OR 0.21 vs combined OR 0.29). In Belgium, hospitalizations declined in children younger than 2 years old, in the first year after vaccination (65%) and the second year after vaccination (80%) [ 70 ].…”

Differentiation between Wild-Type Group A Rotaviruses and Vaccine Strains in Cases of Suspected Horizontal Transmission and Adverse Events Following Vaccination

“…With regard to the introduction of rotavirus vaccines such as Rotavac ® and Rotasiil ® , further vaccine development [53] and the impact of different vaccines on the herd immunity, it is mandatory to monitor virus variability [54]. A previously published study investigated the effectiveness of mixed rotavirus vaccinations [55]. Administration of mixed vaccines will pose a challenge for discrimination between wild-type RVA and vaccine strains in the future.…”