Post-licensure experience with rotavirus vaccination in Latin America and the Caribbean: a systematic review and meta-analysis

Chavers, Tyler; Oliveira, Lúcia Helena de; Parashar, Umesh D.; Tate, Jacqueline E.

doi:10.1080/14760584.2018.1541409

Cited by 20 publications

(24 citation statements)

References 67 publications

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“…The Americas, on the basis of existing efficacy data for the region and consequent WHO recommendation, began to introduce rotavirus vaccines soon after licensure in 2006 [11 ▪ ]. A 2018 meta-analysis of studies from Latin America estimated a vaccine effectiveness of 71% (95% confidence interval (CI) 61–79%) against rotavirus hospitalization in children less than 12 months of age in the region [11 ▪ ]. This same review calculated a median reduction of 43% [interquartile range (IQR) 37–50%] in acute gastroenteritis death rates in children less than 1 year in low-mortality countries, and 45% (IQR: 30–55%) in high-mortality countries.…”

Section: Rotavirus Vaccines In Global Use As Of Mid-2019: Rotarix Andmentioning

confidence: 99%

Current and new rotavirus vaccines

Burke

Tate

Kirkwood

et al. 2019

Current Opinion in Infectious Diseases

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Purpose of reviewAs of 2019, four rotavirus vaccines have been prequalified by the WHO for use worldwide. This review highlights current knowledge regarding rotavirus vaccines available, and provides a brief summary of the rotavirus vaccine pipeline.Recent findingsData generated from use of currently available products supports their effectiveness and impact in diverse settings. Rotavirus vaccines have a favorable risk–benefit profile, but previous associations of rotavirus vaccination with intussusception necessitate continued monitoring for this rare but serious adverse event. Implementation of rotavirus vaccines was jeopardized in late 2018 and 2019 by a shortage of vaccine supply. Fortunately, with the prequalification of two additional vaccines in 2018, countries have increased choice in products with different characteristics, pricing, and implementation strategies. Other vaccines currently in development may open up further immunization strategies, such as neonatal vaccination schedules or parenteral administration.SummaryRotavirus vaccines have demonstrated impact in reducing diarrheal morbidity and mortality worldwide. As countries begin to introduce the newly prequalified vaccines, additional data will become available on the safety and effectiveness of those products. Products in the pipeline have distinct profiles and could be an essential part of the expansion of rotavirus vaccine use worldwide.

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Section: Rotavirus Vaccines In Global Use As Of Mid-2019: Rotarix Andmentioning

confidence: 99%

Current and new rotavirus vaccines

Burke

Tate

Kirkwood

et al. 2019

Current Opinion in Infectious Diseases

Self Cite

130

158

View full text Add to dashboard Cite

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“…WHO recommends the inclusion of rotavirus vaccine in the National Childhood Immunization Program in countries with high incidence of rotavirus infection [16]. Their implementation in many countries has demonstrated a reduction in the disease burden of rotavirus diarrhoea and related death in several geographic regions worldwide [17–20] including sub-Saharan African countries [21]. Rotavirus vaccines are also recommended by the Spanish Paediatric Association since 2008 [22], but they are not funded by the National Health System.…”

Section: Introductionmentioning

confidence: 99%

Rotavirus symptomatic infection among unvaccinated and vaccinated children in Valencia, Spain

et al. 2019

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BackgroundHuman group A rotavirus is the leading cause of severe acute gastroenteritis in young children worldwide. Immunization programs have reduced the disease burden in many countries. Vaccination coverage in the Autonomous Region of Valencia, Spain, is around 40%, as the rotavirus vaccine is not funded by the National Health System. Despite this low-medium vaccine coverage, rotavirus vaccination has substantially reduced hospitalizations due to rotavirus infection and hospital-related costs. However, there are very few studies evaluating symptomatic rotavirus infections not requiring hospitalization in vaccinated children. The objective of this study was to investigate symptomatic rotavirus infections among vaccinated children in the health area served by the Hospital Clínico Universitario of Valencia, Spain, from 2013 to 2015.MethodsA total of 133 children younger than 5 years of age with rotavirus infection were studied. Demographic and epidemiological data were collected and informed consent from their caretakers obtained. Rotavirus infection was detected by immunological methods and G/P rotavirus genotypes were determined by RT-PCR, following standard procedures from the EuroRotaNet network.ResultsForty infants (30.1%; 95% CI: 22.3–37.9) out of 133 were diagnosed with symptomatic rotavirus infection despite having been previously vaccinated, either with RotaTeq (85%) or with Rotarix (15%). Children fully vaccinated against rotavirus (24.8%), partially vaccinated (5.3%) and unvaccinated (69.9%) were found. The infecting genotypes showed high G-type diversity, although no significant differences were found between the G/P genotypes infecting vaccinated and unvaccinated children during the same time period. G9P[8], G12P[8] and G1P[8] were the most prevalent genotypes. Severity of gastroenteritis symptoms required 28 (66.6%) vaccinated and 67 (73.6%) unvaccinated children to be attended at the Emergency Room.ConclusionRotavirus vaccine efficacy in reducing the incidence of severe rotavirus infection has been well documented, but symptomatic rotavirus infection can sometimes occur in vaccinees.

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“…Looking at the number of included reviews per intervention level, two reviews included interventions at the structural level [ 49 , 85 ], twenty-five covered interventions at the public policy level [ 49 , 55 , 58 , 62 , 64 , 68 , 69 , 72 , 78 , 81 , 83 , 85 – 88 , 90 , 91 , 93 , 97 , 98 , 101 , 102 , 104 , 108 , 110 ], twenty-four at the community level [ 50 , 59 , 62 , 64 , 65 , 69 , 72 – 74 , 76 , 78 , 80 , 82 , 84 , 85 , 89 , 92 , 95 – 97 , 99 , 100 , 106 , 109 ] and twenty-five at the individual level [ 48 , 55 – 57 , 60 , 61 , 63 …”

Section: Resultsmentioning

confidence: 99%

“…Regarding approaches to health inequalities adopted by the interventions covered, the vast majority of reviews (forty-five in total) included interventions with a universal approach [ 48 , 50 , 55 , 58 – 63 , 66 – 68 , 71 – 74 , 77 – 81 , 85 – 88 , 90 – 102 , 104 – 108 , 110 ]. Twenty-six reviews included interventions adopting a targeted approach [ 48 , 49 , 54 , 56 , 57 , 62 – 65 , 67 , 68 , 70 , 72 , 75 , 76 , 78 , 82 – 85 , 89 , 92 , 97 , 99 , 103 , 109 ], and ten included a mix of both approaches [ 48 , 62 , 63 , 68 , 72 , 78 , 85 , 92 , 97 , 99 ].…”

Section: Resultsmentioning

confidence: 99%

Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review

et al. 2021

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Despite significant progress in the last few decades, infectious diseases remain a major threat to child health in low- and middle-income countries (LMICs)—particularly amongst more disadvantaged groups. It is imperative to understand the best available evidence concerning which public health interventions reduce morbidity, mortality and health inequalities in children aged under five years. To address this gap, we carried out an umbrella review (a systematic reviews of reviews) to identify evidence on the effects of public health interventions (promotion, protection, prevention) on morbidity, mortality and/or health inequalities due to infectious diseases amongst children in LMICs. Ten databases were searched for records published between 2014–2021 alongside a manual search of gray literature. Articles were quality-assessed using the Assessment of Multiple Systematic Reviews tool (AMSTAR 2). A narrative synthesis was conducted. We identified 60 systematic reviews synthesizing 453 individual primary studies. A majority of the reviews reported on preventive interventions (n = 48), with a minority on promotion (n = 17) and almost no reviews covering health protection interventions (n = 2). Effective interventions for improving child health across the whole population, as well as the most disadvantaged included communication, education and social mobilization for specific preventive services or tools, such as immunization or bed nets. For all other interventions, the effects were either unclear, unknown or detrimental, either at the overall population level or regarding health inequalities. We found few reviews reporting health inequalities information and the quality of the evidence base was generally low. Our umbrella review identified some prevention interventions that might be useful in reducing under five mortality from infectious diseases in LMICs, particularly amongst the most disadvantaged groups.

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Post-licensure experience with rotavirus vaccination in Latin America and the Caribbean: a systematic review and meta-analysis

Cited by 20 publications

References 67 publications

Current and new rotavirus vaccines

Current and new rotavirus vaccines

Rotavirus symptomatic infection among unvaccinated and vaccinated children in Valencia, Spain

Which public health interventions are effective in reducing morbidity, mortality and health inequalities from infectious diseases amongst children in low- and middle-income countries (LMICs): An umbrella review

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