Effectiveness of rotavirus vaccination in prevention of hospital admissions for rotavirus gastroenteritis among young children in Belgium: case-control study

Abstract

Objective : To evaluate the effectiveness of rotavirus vaccination among young children in Belgium. Design : Prospective case-control study. Setting : Random sample of 39 Belgian hospitals, February 2008 to June 2010. Participants : 215 children admitted to hospital with rotavirus gastroenteritis confirmed by polymerase chain reaction and 276 age and hospital matched controls. All children were of an eligible age to have received rotavirus vaccination (that is, born after 1 October 2006 and aged >= 14 weeks). Main outcome measure : Vaccination status of children admitted to hospital with rotavirus gastroenteritis and matched controls. Results : 99 children (48%) admitted with rotavirus gastroenteritis and 244 (91%) controls had received at least one dose of any rotavirus vaccine (P<0.001). The monovalent rotavirus vaccine accounted for 92% (n=594) of all rotavirus vaccine doses. With hospital admission as the outcome, the unadjusted effectiveness of two doses of the monovalent rotavirus vaccine was 90% (95% confidence interval 81% to 95%) overall, 91% (75% to 97%) in children aged 3-11 months, and 90% (76% to 96%) in those aged >= 12 months. The G2P[4] genotype accounted for 52% of cases confirmed by polymerase chain reaction with eligible matched controls. Vaccine effectiveness was 85% (64% to 94%) against G2P[4] and 95% (78% to 99%) against G1P[8]. In 25% of cases confirmed by polymerase chain reaction with eligible matched controls, there was reported co-infection with adenovirus, astrovirus and/or norovirus. Vaccine effectiveness against co-infected cases was 86% (52% to 96%). Effectiveness of at least one dose of any rotavirus vaccine (intention to vaccinate analysis) was 91% (82% to 95%). Conclusions : Rotavirus vaccination is effective for the prevention of admission to hospital for rotavirus gastroenteritis among young children in Belgium, despite the high prevalence of G2P[4] and viral co-infection

Rotavirus vaccination coverage and adherence to recommended age among infants in Flanders (Belgium) in 2012

“…In our study it was not possible to distinguish between vaccine brands; therefore we might have misinterpreted the completeness of the vaccination schedule, since two doses (considered as fully vaccinated in our study) might have been an incomplete vaccination schedule with Rotateq (needing three doses to be complete). However, the two-dose monovalent vaccine Rotarix has the highest market share in Belgium (>85%) [15]. A third dose was documented in 109 children (12.5%; data not shown) [12], which is in line with the market share of the pentavalent vaccine.…”

Causes of Impaired Oral Vaccine Efficacy in Developing Countries

“…[65], [98], [108], [135], [171], [196] [67], [133][134][135], [198][199][200][201] [8], [181], [182], [201], [203], [204] [28], [92], [93], [128], [131], [137], [138], [140], [130], [131], [157], [202] [ [43][44][45], [49], [61][62][63][64][65][66][67][68][69][70], [197] [ [155][156][157] [28], [98], [170][171][172]…”

“…Oral rotavirus vaccines confer homotypic and heterotypic protection against a wide variety of rotavirus genotypes [179,180]. However, as demonstrated in a range of settings, this protection appears to be lower against fully heterotypic strains (i.e., differing from the vaccine at both G and P epitopes) [181,182]. Such exposures may be more frequent in low-income countries, where the circulation of unusual rotavirus strains is more common [183,184].…”

Evaluation of the Cost-Effectiveness of Vaccination of Children with 5-valent Vaccine against Rotavirus Infection in the Russian Federation

“…Систематический обзор наблюдательных исследова-ний эффективности вакцинации против РВИ в Европе [6] обнаружил 9 исследований, в которых анализировалась эффективность вакцинации против РВИ (с примене-нием как 5-валентной, так и одновалентной вакцины) в отношении частоты госпитализации вакцинированных детей по поводу РВИ [7][8][9][10][11][12][13][14][15]. В соответствии с их резуль-татами, средняя величина эффекта при полном курсе вакцинации варьирует в пределах 80-98,3% [6].…”