Rotavirus and the Indigenous Children of the Australian Outback: Monovalent Vaccine Effective in a High‐Burden Setting

Abstract

Indigenous children living in arid Central Australia experience frequent outbreaks of rotavirus gastroenteritis. A widespread outbreak of G9 rotavirus infection occurred several months after introduction of the RIX4414 rotavirus vaccine. We performed a retrospective case-control study to determine vaccine efficacy during the outbreak. Two doses provided an estimated vaccine efficacy of 77.7% (95% confidence interval, 40.2%-91.7%) against hospitalization for gastroenteritis. Vaccine efficacy was 84.5% (95% confidence interval, 23.4%-96.9%) against confirmed cases of rotavirus infection. Vaccination was effective in this high-burden setting.

Novel G10P[14] Rotavirus Strain, Northern Territory, Australia

“…The heterotypic G10P[14] strain identified in these vaccinated children suggests a lack of protective immunity, although it cannot be excluded that vaccination provided protection against severe disease from other genotypes. Vaccine effectiveness against gastroenteritis leading to hospitalization has been variable in NT; vaccine was estimated to be 77.7% effective during a 2007 G9P[8] outbreak ( 11 ) and 19% effective against a fully heterotypic G2P[4] strain in 2009 ( 12 ). Rotarix has been effective for decreasing rotavirus infection notification rates in Darwin, NT ( 10 ), and New South Wales ( 13 ).…”

Oral live attenuated human rotavirus vaccine (RotarixTM) offers sustained high protection against severe G9P[8] rotavirus gastroenteritis during the first two years of life in Brazilian children

“…The fact that such a single-strain (G1P[8]) RV can afford cross-protection early in infancy also became evident in recent, post-vaccine introduction studies performed to assess efficacy "under real conditions" (Snelling et al 2009, Correia et al 2010, Justino et al 2011.…”

Rotavirus Infection: A Perspective on Epidemiology, Genomic Diversity and Vaccine Strategies

“…Of note, the fully heterotypic (non-vaccine) P[4]G2 strain was responsible for all infections in this study, thus confirming the contention that RV1 provides sufficient cross-protection against a broad range of serotypes. Two studies from field settings in Australia also further support that cross-protection occurs after RV1 vaccination, demonstrating that RV1 provided good protection against severe disease from partially heterotypic P [8]G9 (84%) and fully heterotypic P [4]G2 (86%) strains [86]. Rotarix and RotaTeq vaccine were recently found to be contaminated with porcine circovirus viral DNA and were temporarily suspended by US FDA in March 2010.…”