Hospital-Based Surveillance and Analysis of Genotype Variation in Nicaragua After the Introduction of the Pentavalent Rotavirus Vaccine

Abstract

No new or unexpected strains were predominant in the years immediately following the introduction of RV5 into Nicaragua. RV5 does not appear to have substantially altered the historical pattern of seasonal fluctuation in rotavirus genotypes.

Effectiveness of Pentavalent Rotavirus Vaccine Against a Diverse Range of Circulating Strains in Nicaragua

“…In contrast, the fully homotypic G1P [8] and G3P [8] strains became predominant during years 2 and 3, respectively, after vaccine introduction. Previous surveillance has shown that G2P [4] was present in the year before vaccine uptake in Nicaragua, supporting natural secular variation as the likely cause of the G2P [4] predominance in 2008 [11]. Similarly, year-to-year strain changes were common before the introduction of RotaTeq in Nicaragua [10].…”

“…Secular strain variation before the introduction of RotaTeq was quite common in Nicaragua, changing from G2P [4] in 2001, to G1P [8] in 2002, and G3P [8] in 2003 [10]. During the 2006-2007 rotavirus season in Nicaragua, when few children had yet to be vaccinated, the partially heterotypic G2P [4] strain and the fully homotypic G4P [8] strain comprised approximately 40.5% and 53.2%, respectively, of the circulating rotavirus strains [11]. However, in 2007-2008, the first rotavirus season after one birth cohort was vaccinated with RotaTeq, G2P [4] became the predominant circulating strain in Nicaragua, suggesting natural fluctuation as the likely cause of the strain predominance [6].…”

Rotavirus Strain Trends During the Postlicensure Vaccine Era: United States, 2008–2013

“…We cannot exclude the possibility that RotaTeq selects for genotype G3P[8], but, if this is true, the shift to this genotype appears to be short-lived following vaccine introduction. In Nicaragua, a country with high RotaTeq coverage, a switch to G3P[8] predominance did not occur after vaccine introduction [31], but in 2012–2013 a very high prevalence of G12P[8] strains was documented [22]. The emergence of G12P[8] in the United States and other countries may reflect a new trend in RVA genotype prevalence that is not driven by vaccine pressure.…”

Impact of vaccination on the molecular epidemiology and evolution of group A rotaviruses in Latin America and factors affecting vaccine efficacy

“…re-emergence ofG2P[4] strains(Khawaja et al, 2014; Patel et al, 200 2009). During this time period, a study found that the effectiveness 201 of 3 doses of RV5 against rotavirus disease requiring admission or 202 treatment with intravenous rehydration was 46% (95% CI, 18-64%)203 and that a single RV strain(G2P[4]) was identified in 88% of the RV 204 cases(Patel et al, 2009).…”