Sustained low rotavirus activity and hospitalisation rates in the post-vaccination era in Belgium, 2007 to 2014

Abstract

In 2006, Belgium was the first country in the European Union to recommend rotavirus vaccination in the routine infant vaccination schedule and rapidly achieved high vaccine uptake (86-89% in 2007). We used regional and national data sources up to 7 years post-vaccination to study the impact of vaccination on laboratory-confirmed rotavirus cases and rotavirus-related hospitalisations and deaths. We showed that (i) from 2007 until 2013, vaccination coverage remained at 79-88% for a complete course, (ii) in children 0-2 years, rotavirus cases decreased by 79% (95% confidence intervals (CI): 68--89%) in 2008-2014 compared to the pre-vaccination period (1999--2006) and by 50% (95% CI: 14-82%) in the age group ≥ 10 years, (iii) hospitalisations for rotavirus gastroenteritis decreased by 87% (95% CI: 84-90%) in 2008--2012 compared to the pre-vaccination period (2002--2006), (iv) median age of rotavirus cases increased from 12 months to 17 months and (v) the rotavirus seasonal peak was reduced and delayed in all post-vaccination years. The substantial decline in rotavirus gastroenteritis requiring hospitalisations and in rotavirus activity following introduction of rotavirus vaccination is sustained over time and more pronounced in the target age group, but with evidence of herd immunity.

Disease burden and seasonal impact of improving rotavirus vaccine coverage in the United States: A modeling study

“…The emergence of biennial epidemic patterns of RVGE incidence in the U.S. after the introduction of a national vaccine program may be driven by accumulation of susceptible following modest vaccine coverage. Other developed countries with high coverage of rotavirus vaccination (>85%), such as Belgium, Austria, Australia, Finland, and Germany, have not experienced the biennial epidemic patterns after vaccine introduction [14][15][16][17][18]. Our model predicted that RVGE incidence shifted from a biennial pattern to an annual pattern when vaccine coverage reached 85%.…”

“…Unvaccinated children drive the higher rotavirus hospitalizations in the biennial patterns [5]. In contrast, other developed countries with high coverage of rotavirus vaccination (>85%), such as Belgium, Austria, Australia, Finland, and Germany, did not have the biennial epidemic patterns after the introduction of vaccines [14][15][16][17][18].…”

Rotavirus vaccine effectiveness in preventing hospitalizations due to gastroenteritis: a descriptive epidemiological study from Germany

“…Typical human RVA rotaviruses were most frequent, including G3P [8], G1P [8], G9P [8], G4P [8], G2P [4] and G12P [8] genotypes. Uncommon genotypes such as G12P [6], G1P [4], G1P [6] and G8P [4] remained rare ( Table 1). Mixed RVA infections were present in seven samples.…”

“…Both vaccines, RV1 and RV5, are in equal use in Saxony [4]. Significant reductions in the incidence of childhood diarrhoea-related hospitalization were observed in several developed countries after the introduction of routine RV vaccination [5,6]. To evaluate the impact of vaccine introduction in Germany, we monitored RVA-related hospitalizations in Leipzig, Saxony, over a period of 15 years.…”

Differences in the amino acid composition of the antigen epitopes of the VP7 protein of Russian rotaviruses with the G9 genotype and the vaccine strains RotaTeq, Rotavac, and Rotarix

“…в сайтах VP7 РВА, изолированных в Нижнем Новгороде в 2011-2016 гг. При этом в Бельгии была показана высокая эффективность вакцинации с существенным снижением тяжелых случаев ротавирусного гастроэнтерита [24].…”