Effectiveness of Rotavirus Vaccination: A Systematic Review of the First Decade of Global Postlicensure Data, 2006–2016

Abstract

Two rotavirus vaccines, Rotarix (RV1) and RotaTeq (RV5), were licensed for global use in 2006. A systematic review of 48 peer- reviewed articles with postlicensure data from 24 countries showed a median RV1 vaccine effectiveness (VE) of 84%, 75%, and 57% in countries with low, medium, and high child mortality, respectively, and RV5 VE of 90% and 45% in countries with low and high child mortality, respectively. A partial vaccine series provided considerable protection, but not to the same level as a full series. VE tended to decline in the second year of life, particularly in medium- and high-mortality settings, and tended to be greater against more severe rotavirus disease. Postlicensure data from countries across geographic regions and with different child mortality levels demonstrate that under routine use, both RV1 and RV5 are effective against rotavirus disease, supporting the World Health Organization recommendation that all countries introduce rotavirus vaccine into their national immunization program.

Rotavirus infections in children in Turkey: A systematic review

“…There was a diversity of rotavirus genotypes, and a variety of unusual rotavirus strains was also identified. This is a similar pattern observed in developing countries where the effectiveness of rotavirus vaccines is lower than the developed countries . These results emphasize the evolving nature of rotaviruses and may be important while evaluating the heterotypic protection of vaccines.…”

“…Two rotavirus vaccines, monovalent (RV1) and pentavalent (RV5), were approved for preventing rotavirus diarrhea and licensed in many countries. The data about the efficacy and effectiveness for both vaccines provided evidence to conclude that they are efficacious and effective in preventing severe rotavirus gastroenteritis (RVGE) and rotavirus deaths in children aged less than 5 years in both developed and developing countries . The effectiveness of rotavirus vaccines in clinical presentations other than gastroenteritis is unknown.…”

“…The data about the efficacy and effectiveness for both vaccines provided evidence to conclude that they are efficacious and effective in preventing severe rotavirus gastroenteritis (RVGE) and rotavirus deaths in children aged less than 5 years in both developed and developing countries. 4 The effectiveness of rotavirus vaccines in clinical presentations other than gastroenteritis is unknown. The World Health Organization (WHO) has recommended the inclusion of rotavirus vaccines in the national immunization programs of all countries; however, coverage rate of rotavirus vaccines is around 25% all over the world.…”

Effectiveness of live attenuated monovalent human rotavirus vaccination in rural Ecuador, 2008-2013

“…In 2006 the Rotarix and Rotateq vaccines were approved with the objective of reducing severe rotavirus [3,4]. While both vaccines have shown similar effectiveness, Rotarix is used in Ecuador and in most lower-and-middle income countries (LMICs) because of its better cost effectiveness, lower dose requirements, and thermostability [5][6][7]. In general, Rotarix vaccination is thought to be most effective against severe rotavirus infection and decreases the burden of severe diarrhea in populations where it is introduced [8][9][10][11][12][13][14].…”

“…In general, Rotarix vaccination is thought to be most effective against severe rotavirus infection and decreases the burden of severe diarrhea in populations where it is introduced [8][9][10][11][12][13][14]. However, most studies on rotavirus vaccine performance have come from clinical populations; data on how the vaccine performs against milder disease and asymptomatic infections especially are lacking [5]. Moreover, many of the prior studies have focused on large cities [8][9][10][11]; data on how the vaccine performs in community settings, particularly in rural settings, are needed [5].…”