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Rotavirus vaccine effectiveness in Latin American and Caribbean countries: A systematic review and meta-analysis.
Vaccine 2015; 33 Suppl 1:A248-54V

Abstract

INTRODUCTION

There are two group A rotavirus (RVA) vaccines available worldwide since 2006: monovalent (Rotarix(®), RV1) and pentavalent (RotaTeq(®), RV5). Currently, 16 countries and 1 territory in Latin America and the Caribbean (LAC) have introduced RVA vaccines and since their introduction several impact and effectiveness studies have been conducted in different countries. The purpose of this study was to assess RVA vaccine effectiveness in LAC countries.

METHODOLOGY

We conducted a systematic review and meta-analysis of studies in children under-five who were admitted with laboratory-confirmed RVA diarrhea. We searched Medline, WOS, LILACS, Scopus, and other sources from 2006 to October 2013. Two independent evaluators identified the studies that met predefined selection criteria and extracted relevant information according to a protocol. Pooled estimates were obtained with fixed and random-effects models and stratified according to selected effect modifiers.

RESULTS

Of the 806 articles meeting the initial criteria, 8 case-control studies which involved 27,713 participants (6265 cases and 21,448 controls) were included in the final analyses. The pooled estimates were calculated using different types of controls, leading to different degrees of effectiveness. The effectiveness of two doses of RV1 against rotavirus-related hospitalizations ranged from 63.5% (95% CI: 39.2-78.0) to 72.2% (95%CI: 60.9-80.2). Effectiveness ranged from 75.4% (95%CI: 64.6-82.9) to 81.8% (CI 95%:72.3-88.1) among infants <12 months for RV1, and from 56.5% (95%CI: 26.2-74.3) to 66.4% (95%CI: 54.1-75.5) for infants >12 months. The RV5 effectiveness for diarrhea with a Vesikari score >11 in infants 6 to 11 months old ranged from 76.1% (95%CI: 57.6-86.6) to 88.8% (95%CI: 78.3-94.3). Also, it showed 63.5% (95%CI: 29.4-82.6) of effectiveness against G2P [4].

CONCLUSION

RVA vaccines consistently showed protection against diarrhea-related hospitalizations in LAC. Results were more robust for RV1. Effectiveness was shown with different types of controls, but appeared somewhat higher with community controls. Effectiveness was higher among infants <12 months and lower in older children.

Authors+Show Affiliations

Comprehensive Family Immunization Project, Pan American Health Organization, Washington, DC, USA. Electronic address: oliveirl@paho.org.Brazilian National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.Brazilian National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.Comprehensive Family Immunization Project, Pan American Health Organization, Washington, DC, USA.Laboratory of Comparative and Environmental Virology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25919169

Citation

de Oliveira, Lúcia Helena, et al. "Rotavirus Vaccine Effectiveness in Latin American and Caribbean Countries: a Systematic Review and Meta-analysis." Vaccine, vol. 33 Suppl 1, 2015, pp. A248-54.
de Oliveira LH, Camacho LA, Coutinho ES, et al. Rotavirus vaccine effectiveness in Latin American and Caribbean countries: A systematic review and meta-analysis. Vaccine. 2015;33 Suppl 1:A248-54.
de Oliveira, L. H., Camacho, L. A., Coutinho, E. S., Ruiz-Matus, C., & Leite, J. P. (2015). Rotavirus vaccine effectiveness in Latin American and Caribbean countries: A systematic review and meta-analysis. Vaccine, 33 Suppl 1, pp. A248-54. doi:10.1016/j.vaccine.2014.11.060.
de Oliveira LH, et al. Rotavirus Vaccine Effectiveness in Latin American and Caribbean Countries: a Systematic Review and Meta-analysis. Vaccine. 2015 May 7;33 Suppl 1:A248-54. PubMed PMID: 25919169.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rotavirus vaccine effectiveness in Latin American and Caribbean countries: A systematic review and meta-analysis. AU - de Oliveira,Lúcia Helena, AU - Camacho,Luiz Antonio Bastos, AU - Coutinho,Evandro Silva Freira, AU - Ruiz-Matus,Cuauhtemoc, AU - Leite,José Paulo Gagliardi, PY - 2014/05/15/received PY - 2014/08/26/revised PY - 2014/11/17/accepted PY - 2015/4/29/entrez PY - 2015/4/29/pubmed PY - 2016/1/30/medline KW - Latin America and the Caribbean region KW - Meta-analysis KW - Rotavirus vaccine effectiveness KW - Rotavirus vaccines SP - A248 EP - 54 JF - Vaccine JO - Vaccine VL - 33 Suppl 1 N2 - INTRODUCTION: There are two group A rotavirus (RVA) vaccines available worldwide since 2006: monovalent (Rotarix(®), RV1) and pentavalent (RotaTeq(®), RV5). Currently, 16 countries and 1 territory in Latin America and the Caribbean (LAC) have introduced RVA vaccines and since their introduction several impact and effectiveness studies have been conducted in different countries. The purpose of this study was to assess RVA vaccine effectiveness in LAC countries. METHODOLOGY: We conducted a systematic review and meta-analysis of studies in children under-five who were admitted with laboratory-confirmed RVA diarrhea. We searched Medline, WOS, LILACS, Scopus, and other sources from 2006 to October 2013. Two independent evaluators identified the studies that met predefined selection criteria and extracted relevant information according to a protocol. Pooled estimates were obtained with fixed and random-effects models and stratified according to selected effect modifiers. RESULTS: Of the 806 articles meeting the initial criteria, 8 case-control studies which involved 27,713 participants (6265 cases and 21,448 controls) were included in the final analyses. The pooled estimates were calculated using different types of controls, leading to different degrees of effectiveness. The effectiveness of two doses of RV1 against rotavirus-related hospitalizations ranged from 63.5% (95% CI: 39.2-78.0) to 72.2% (95%CI: 60.9-80.2). Effectiveness ranged from 75.4% (95%CI: 64.6-82.9) to 81.8% (CI 95%:72.3-88.1) among infants <12 months for RV1, and from 56.5% (95%CI: 26.2-74.3) to 66.4% (95%CI: 54.1-75.5) for infants >12 months. The RV5 effectiveness for diarrhea with a Vesikari score >11 in infants 6 to 11 months old ranged from 76.1% (95%CI: 57.6-86.6) to 88.8% (95%CI: 78.3-94.3). Also, it showed 63.5% (95%CI: 29.4-82.6) of effectiveness against G2P [4]. CONCLUSION: RVA vaccines consistently showed protection against diarrhea-related hospitalizations in LAC. Results were more robust for RV1. Effectiveness was shown with different types of controls, but appeared somewhat higher with community controls. Effectiveness was higher among infants <12 months and lower in older children. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/25919169/Rotavirus_vaccine_effectiveness_in_Latin_American_and_Caribbean_countries:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(14)01639-9 DB - PRIME DP - Unbound Medicine ER -