Determining the effectiveness of the pentavalent rotavirus vaccine against rotavirus hospitalizations and emergency department visits using two study designs

Donauer, Stephanie; Payne, Daniel C.; Edwards, Kathryn M.; Szilâgyi, Peter G.; Hornung, Richard; Weinberg, Geoffrey A.; Chappell, James D.; Hall, Caroline Breese; Parashar, Umesh D.; Staat, Mary Allen

doi:10.1016/j.vaccine.2013.03.072

Cited by 23 publications

(13 citation statements)

References 48 publications

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“…We observed the same racial disparities in rotavirus vaccination and rotavirus related infection rates that have been previously reported [4,11,17,19–21,30,31]. However, our disparities were not limited to just those with rotavirus AGE, but also, we noted disparities among those who had diarrhea from other causes despite cases and controls being enrolled from the same source population.…”

Section: Discussionsupporting

confidence: 87%

“…Severity of diarrheal disease was determined using a modified Vesikari scale [21], whereby >11 score was categorized as severe [17,22]. Assessment of severity was prospectively obtained from health records and survey questionnaire responses given at the time of enrollment.…”

Section: Methodsmentioning

confidence: 99%

“…In developed countries, rotavirus vaccines have demonstrated high efficacy against severe rotavirus disease [13] and a decrease in disease severity [14–16]. Rates of rotavirus related hospitalizations and emergency department visits were similarly reduced between children who received 2 doses of RV5 (incomplete) compared to those who had received 3 doses of RV5 (complete) [17]. …”

Section: Introductionmentioning

confidence: 99%

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Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis

Mohammed

Immergluck

Parker

et al. 2015

Vaccine

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Introduction Rotavirus remains the leading cause of severe diarrhea in children under 5 years worldwide. In the US, Rotarix® (RV1) and RotaTeq® (RV5), have been associated with reductions in and severity of rotavirus disease. Studies have evaluated the impact of RV1 or RV5 but little is known about the impact of incomplete or mixed vaccination upon vaccine effectiveness. Methods Case control study to examine association of combined RV1 and RV5 and rotavirus acute gastroenteritis, factoring severity of diarrheal disease. Children born after March 1, 2009 with acute gastroenteritis from three pediatric hospitals in Atlanta, Georgia were approached for enrollment. Survey was administered, stool specimen was collected, and vaccination records were obtained. Results 891 of 1127 children with acute gastroenteritis were enrolled. Stool specimens were collected from 708 for rotavirus testing; 215 stool samples tested positively for rotavirus. Children >12 months of age were more likely to have rotavirus. Children categorized with Vesikari score of >11 were almost twice as likely to be rotavirus positive. Prior rotavirus vaccination decreased the mean Vesikari score, p < 0.0001. Children with complete single type vaccination were protected against rotavirus (OR 0.21, 95% CI: 0.14–0.31, p < 0.0001). Conclusion Complete rotavirus vaccination with a single vaccine type resulted in protection against rotavirus diarrhea and decrease in severity of rotavirus gastroenteritis. Incomplete rotavirus vaccination either with a single vaccine or mixed vaccination types also provided some protection.

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Section: Discussionsupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis

Mohammed

Immergluck

Parker

et al. 2015

Vaccine

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“…The initial search strategy identified 2,097 studies as potentially relevant; of these, 30 were eligible for inclusion in the review (Fig. 1 ) [ 16 – 45 ]. Two summary tables of study characteristics are available in Additional file 1 .…”

Section: Resultsmentioning

confidence: 99%

Population effectiveness of the pentavalent and monovalent rotavirus vaccines: a systematic review and meta-analysis of observational studies

et al. 2017

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BackgroundRotavirus was the leading cause of acute gastroenteritis (AGE) in infants and young children prior to the introduction of routine vaccination. Since 2006 there have been two licensed vaccines available; with successful clinical trials leading the World Health Organization to recommend rotavirus vaccination for all children worldwide. In order to inform immunisation policy we have conducted a systematic review and meta-analysis of observation studies to assess population effectiveness against acute gastroenteritis.MethodsWe systematically searched PubMed, Medline, Web of Science, Cinhal and Academic Search Premier and grey literature sources for studies published between January 2006 and April 2014. Studies were eligible for inclusion if they were observational measuring population effectiveness of rotavirus vaccination against health care attendances for rotavirus gastroenteritis or AGE. To evaluate study quality we use used the Newcastle-Ottawa Scale for non-randomised studies, categorising studies by risk of bias. Publication bias was assessed using funnel plots. If two or more studies reported a measure of vaccine effectiveness (VE), we conducted a random effects meta-analysis. We stratified analyses by World Bank country income level and used study quality in sensitivity analyses.ResultsWe identified 30 studies, 19 were from high-income countries and 11 from middle-income countries. Vaccine effectiveness against hospitalization for laboratory confirmed rotavirus gastroenteritis was highest in high-income countries (89% VE; 95% CI 84-92%) compared to middle-income countries (74% VE; 95% CI 67-80%). Vaccine effectiveness was higher for those receiving the complete vaccine schedule (81% VE; 95% CI 75-86%) compared to partial schedule (62% VE; 95% CI 55-69%). Two studies from high-income countries measured VE against community consultations for AGE with a pooled estimate of 40% (95% CI 13-58%; 2 studies).ConclusionsWe found strong evidence to further support the continued use of rotavirus vaccines. Vaccine effectiveness was similar to that reported in clinical trials for both high and middle-income countries. There is limited data from Low income settings at present. There was lower effectiveness against milder disease. Further studies, should continue to report effectiveness against AGE and less-severe rotavirus disease because as evidenced by pre-vaccine introduction studies this is likely to contribute the greatest burden on healthcare resources, particularly in high-income countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2613-4) contains supplementary material, which is available to authorized users.

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“…The effectiveness of rotavirus vaccines has been reported in numerous studies based on hospitals, emergencies departments and primary care settings, or using population-based surveillance methodology [16,17]. Our report represents the first case-control study matched by gender and age that analyses risk factors for rotavirus infection conducted in Spain, and contributes to assessing rotavirus vaccine effectiveness in Europe.…”

Section: Discussionmentioning

confidence: 88%

A Matched Case-Control Study Measuring the Effectiveness of the Rotavirus Vaccines to Prevent Gastroenteritis Hospitalizations

Giménez-Sánchez¹

2015

J Vaccines Vaccin

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Rotavirus has been identified as an important cause of diarrhea hospitalizations. Two oral live rotavirus vaccines have been licensed in Europe since 2006 and have been available in the Spanish market since then. The main objective of this study was to estimate the effectiveness of the rotavirus vaccination in the prevention of admissions caused by rotavirus infections using a matched case-control study in a hospital setting. Patients and methods: Prospective, hospital based, matched case-control study including patients between aged between 2 months and 5 years, hospitalized during 2008-2010 with a diagnosis of Rotavirus Acute Gastroenteritis (RV+AGE) matched against two patients diagnosed as Rotavirus negative Acute Gastroenteritis (Control group A) and five patients hospitalized with non-gastrointestinal conditions (Control group B) (i.e. in the ratio 1:2:5). Results: 466 patients were included: 57 cases of RV+AGE, 104 patients in Control group A and 305 in Control group B. No differences were found among the 3 groups when comparing demographic data. Vaccine effectiveness was estimated as 86% (95% CI 59-95) compared to group A and 88% (95% CI 68-95) compared to group B. Prior rotavirus vaccination was more frequent in mild cases than in those with moderate-severe symptoms and the length of admission was shorter in vaccine recipients (1.7 ± 0.8 days) compared to those non-vaccinated (3.2 ± 1.4 days) (p<0.001; 95% CI: 1.3-1.7). Conclusions: Our study found the rotavirus vaccines to be highly effective in preventing rotavirus-related hospitalizations and to reduce the severity of the rotavirus disease.

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Determining the effectiveness of the pentavalent rotavirus vaccine against rotavirus hospitalizations and emergency department visits using two study designs

Cited by 23 publications

References 48 publications

Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis

Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis

Population effectiveness of the pentavalent and monovalent rotavirus vaccines: a systematic review and meta-analysis of observational studies

A Matched Case-Control Study Measuring the Effectiveness of the Rotavirus Vaccines to Prevent Gastroenteritis Hospitalizations

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