Universal rotavirus vaccination program in Sicily: Reduction in health burden and cost despite low vaccination coverage

Costantino, Claudio; Restivo, Vincenzo; Tramuto, Fabio; Casuccio, Alessandra; Vitale, Francesco

doi:10.1080/21645515.2018.1471306

Cited by 15 publications

(8 citation statements)

References 33 publications

(32 reference statements)

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“…In Europe, in 2012 the annual incidence of community-acquired rotavirus AGE among children under 5 years of age ranged from 1.33 to 4.96 cases per 100 person-years, while the annual incidence of nosocomial infection ranged from 0 to 1.87 cases per 1000 days of hospitalization (0-68.2 per 100 person-years in hospital) [8]. The recent introduction of rotavirus vaccines reduced mortality, hospitalization rates, and the overall number of cases [9][10][11], but these effects were markedly higher in low-mortality countries since access to the vaccine in high-mortality countries is still too limited [1,9]. Moreover, other factors such as differences in gut microbiome and human leukocyte antigen groups may play a role in reducing rotavirus vaccine efficacy in low-income countries [12].…”

Section: Introductionmentioning

confidence: 99%

The evolving epidemiology of acute gastroenteritis in hospitalized children in Italy

Stanyevic

Sepich

Biondi³

et al. 2021

Eur J Pediatr

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Few data are available on the prevalence and features of acute gastroenteritis (AGE) in hospitalized children in Italy, where specific rotavirus vaccines were introduced into the national vaccination plan in 2017. To evaluate vaccination effects on AGE epidemiology, we analysed data from children aged ≤ 18 years admitted for AGE at the University Hospital of Pisa in 2019, comparing them with those recorded in 2012. Demographical, clinical, diagnostic, and treatment data were collected reviewing medical records and were therefore compared. In 2019 and 2012, 86 (median age 2.5 years [IQR 1.4–5.9]) and 85 children (median age 2.3 years [IQR 1.3–5.1]) were respectively admitted with AGE. The most common symptoms were diarrhoea and vomiting; decreased skin turgor was more frequent in 2019 (54% and 34% respectively, p = 0.01). Viral infections were more common than bacterial ones; in 2019, a decrease in rotavirus infections (67% and 22%, p = 0.003) and an increase in adenovirus infections (50% and 10%, p = 0.002) and in the number of patients with negative stool testing (58% and 39%, p = 0.04) were found.Conclusions: Viral infections are the leading cause of AGE in hospitalized children in Italy. The introduction of rotavirus vaccines did not reduce the number of hospitalizations per year. Adenovirus and other non-routinely screened viruses may be undergoing a selection process making them common causative agents for AGE. What is Known:• Rotavirus is the leading cause of acute severe gastroenteritis in children worldwide, especially < 5 years of age.• The introduction of specific vaccines may be changing its epidemiology.• Few data are available on acute gastroenteritis in hospitalized children in Italy. What is New:• Viral infections are the leading cause of acute gastroenteritis in hospitalized children in Italy.• Specific vaccines are reducing rotavirus infections, but adenovirus and other non-routinely screened viruses may be undergoing a selection process making them common causative agents for gastroenteritis.

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Section: Introductionmentioning

confidence: 99%

The evolving epidemiology of acute gastroenteritis in hospitalized children in Italy

Stanyevic

Sepich

Biondi³

et al. 2021

Eur J Pediatr

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“…Vaccination is universally recognized as one of the best strategies to increase duration and quality of life during the last centuries [ 1 ]. Nevertheless, vaccination coverage rates are under the levels recommended to limit spread and to reduce the burden on health systems of vaccine-preventable diseases [ 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Vaccination and Vaccine Effectiveness: A Commentary of Special Issue Editors

2020

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The Special Issue “Vaccination and Vaccine Effectiveness”, published in the journal Vaccines, has the main aim to increase international literature data on vaccine effectiveness and safety and on vaccination strategies in order to reduce vaccine hesitancy and improve vaccination coverage rates. The main topics included in the call for papers were vaccines administered to infants, adolescents, adults, elderly people, at-risk populations (due to comorbidities and personal risk factors) and healthcare workers and strategies adopted to promote vaccination adherence among these categories. This Special Issue started from the assumption that, despite vaccination being universally recognized as one of the best strategies to increase duration and quality of life during the last centuries, vaccination coverage rates are often under the levels recommended to reduce circulation and to extinguish vaccine-preventable diseases. Vaccine hesitancy involves at least 15% of the general population, and healthcare workers also sometimes demonstrate doubts on vaccination effectiveness and safety. At the end of the six-month submission period, 16 articles (15 research article and one review) were accepted after the peer-review processes and published online.

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“…In addition, a debate about the benefits of anti-RVA vaccination is still ongoing among physicians [19]. For these reasons, the anti-RVA vaccination coverage in Italy is still low (8%) and not homogeneous among the different Italian regions (range: 0–40%), which have autonomy in the decision about non-mandatory vaccinations and started the programmes at different times [20].…”

Section: Introductionmentioning

confidence: 99%

Group A rotavirus surveillance before vaccine introduction in Italy, September 2014 to August 2017

et al. 2019

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Introduction Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in young children, causing ca 250,000 deaths worldwide, mainly in low-income countries. Two proteins, VP7 (glycoprotein, G genotype) and VP4 (protease-sensitive protein, P genotype), are the basis for the binary RVA nomenclature. Although 36 G types and 51 P types are presently known, most RVA infections in humans worldwide are related to five G/P combinations: G1P[8], G2P[4], G3P[8], G4P[8], G9P[8]. Aim This study aimed to characterise the RVA strains circulating in Italy in the pre-vaccination era, to define the trends of circulation of genotypes in the Italian paediatric population. Methods Between September 2014 and August 2017, after routine screening in hospital by commercial antigen detection kit, 2,202 rotavirus-positive samples were collected in Italy from children hospitalised with AGE; the viruses were genotyped following standard European protocols. Results This 3-year study revealed an overall predominance of the G12P[8] genotype (544 of 2,202 cases; 24.70%), followed by G9P[8] (535/2,202; 24.30%), G1P[8] (459/2,202; 20.84%) and G4P[8] (371/2,202; 16.85%). G2P[4] and G3P[8] genotypes were detected at low rates (3.32% and 3.09%, respectively). Mixed infections accounted for 6.49% of cases (143/2,202), uncommon RVA strains for 0.41% of cases (9/2,202). Conclusions The emergence of G12P[8] rotavirus in Italy, as in other countries, marks this genotype as the sixth most common human genotype. Continuous surveillance of RVA strains and monitoring of circulating genotypes are important for a better understanding of rotavirus evolution and genotype distribution, particularly regarding strains that may emerge from reassortment events.

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Universal rotavirus vaccination program in Sicily: Reduction in health burden and cost despite low vaccination coverage

Cited by 15 publications

References 33 publications

The evolving epidemiology of acute gastroenteritis in hospitalized children in Italy

The evolving epidemiology of acute gastroenteritis in hospitalized children in Italy

Vaccination and Vaccine Effectiveness: A Commentary of Special Issue Editors

Group A rotavirus surveillance before vaccine introduction in Italy, September 2014 to August 2017

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