Rotavirus Vaccination in Central Europe

Abstract

Each year, rotavirus (RV) infection is the leading cause of acute gastroenteritis requiring hospitalisation and of nosocomially transmitted diseases in children younger than 5 years across Central European Vaccination Awareness Group (CEVAG) countries; however, inadequate surveillance systems and lack of routine RV testing still exist in most CEVAG countries, making it difficult to accurately assess the present burden of acute RV gastroenteritis in the younger population. Furthermore, routine immunisation of infants with RV vaccines has not been implemented, and no official and uniform recommendations exist in most of the countries in these territories. The present study provides CEVAG country-specific estimates of the disease burden of RV gastroenteritis among the youngest population and presents evidence-based advice on the use of RV vaccines in the region, while providing a framework for vaccination at the national level.

Rotavirus gastroenteritis in children less than five years of age in primary care settings in Bulgaria: an observational study

“…These hospital-based studies performed between 2005 and 2008 reported that 28%-43% of the incidence of AGE and at least a third of all the hospitalizations of children less than five years old could be attributed to RV. 15,16 Overall, only 6.3% of the children in the study were hospitalized, 20.1% of the RVpositive and 1.5% of the RV-negative.…”

“…The existing incidence data for Bulgaria are based on hospitalized cases [15][16][17] but they include only the more severe cases and do not give an accurate impression of the epidemiology and actual burden of RV disease. By one estimate, up to one in five AGE cases will see a physician and no more than two percent will be admitted to a hospital or present to an emergency room while the remaining cases will be cared for in their home by the parents or other caregivers.…”

Immunization of high-risk paediatric populations: Central European Vaccination Awareness Group recommendations

“…25 Not yet included in the NIP, but the Romanian MoH will begin a second campaign for vaccination of schoolgirls (>12 years, three doses). 26 Recommended (not mandatory) for 12-year-old girls, partially reimbursed. 27 Administered to all unvaccinated girls, and girls only vaccinated once previously.…”

“…USA recommendations issued annually by the Advisory Committee on Immunization Practices (ACIP) are included for comparison. Exceptions to the mandatory or fully reimbursed immunizations are given in the footnotes (6,22,23,26,31,33) to TABLE 1.…”

“…The ACIP classifies children with chronic heart disease as having an underlying comorbidity that is an indication for pneumococcal vaccination [23] and children <18 years with heart disease as a high-risk group for influenza [22]. Rotavirus immunization is recommended in some countries due to frequent hospitalization and increased exposure to nosocomial gastroenteritis [26]. Additionally, infants with symptomatic cardiac disease are at increased risk of complicated RSV bronchiolitis [19,27].…”