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Sustained Effectiveness of Rotavirus Vaccine Against Very Severe Rotavirus Disease Through the Second Year of Life, Bolivia 2013-2014.
Clin Infect Dis. 2016 May 01; 62 Suppl 2:S115-20.CI

Abstract

BACKGROUND

In Bolivia, monovalent rotavirus vaccine was introduced in 2008 and a previous evaluation reported a vaccine effectiveness (VE) of 77% with 2 doses of vaccine in children aged <3 years. This evaluation sought to determine if rotavirus vaccine provided protection through the second year of life against circulating genotypes.

METHODS

A case-control study was performed in 5 hospitals from April 2013 to March 2014. Among enrolled participants who met study criteria and had rotavirus stool testing performed and vaccine status confirmed, we calculated VE using a logistic regression model. Subgroup analyses were performed among children aged <1 year and those aged ≥1 year, among children with severe diarrhea (Vesikari score ≥11) and very severe diarrhea (Vesikari score ≥15), and among G and P strains with at least 40 specimens.

RESULTS

A total of 776 children were enrolled. For children <1 year and ≥1 year of age with severe diarrhea, VE for 2 doses was 75% (95% confidence interval [CI], 46%-88%) and 53% (95% CI, 9%-76%), respectively. For children <1 year and ≥1 year of age with very severe diarrhea, VE for 2 doses was 80% (95% CI, 44%-93%) and 74% (95% CI, 35%-90%), respectively. Genotype-specific analysis demonstrated similar VE for the 4 most common G and P types (G3, G9, P[6] and P[8]).

CONCLUSIONS

A monovalent rotavirus vaccine remains effective against a broad range of circulating strains as part of a routine immunization program >5 years after its introduction in Bolivia. Although VE appears to wane in children aged ≥1 year, it still provides significant protection, and does not wane against severe disease.

Authors+Show Affiliations

Division of Viral Diseases, National Center for Immunization and Respiratory Diseases Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Programa Ampliado de Inmunización, Ministerio de Salud.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Facultad de Ciencias Puras y Naturales, Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.Facultad de Ciencias Puras y Naturales, Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés.Pan American Health Organization, La Paz, Bolivia.Programa Ampliado de Inmunización, Ministerio de Salud.Pan American Health Organization, Washington D.C.Division of Viral Diseases, National Center for Immunization and Respiratory Diseases.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

27059344

Citation

Pringle, Kimberly D., et al. "Sustained Effectiveness of Rotavirus Vaccine Against Very Severe Rotavirus Disease Through the Second Year of Life, Bolivia 2013-2014." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62 Suppl 2, 2016, pp. S115-20.
Pringle KD, Patzi M, Tate JE, et al. Sustained Effectiveness of Rotavirus Vaccine Against Very Severe Rotavirus Disease Through the Second Year of Life, Bolivia 2013-2014. Clin Infect Dis. 2016;62 Suppl 2:S115-20.
Pringle, K. D., Patzi, M., Tate, J. E., Iniguez Rojas, V., Patel, M., Inchauste Jordan, L., Montesano, R., Zarate, A., De Oliveira, L., & Parashar, U. (2016). Sustained Effectiveness of Rotavirus Vaccine Against Very Severe Rotavirus Disease Through the Second Year of Life, Bolivia 2013-2014. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62 Suppl 2, S115-20. https://doi.org/10.1093/cid/civ1026
Pringle KD, et al. Sustained Effectiveness of Rotavirus Vaccine Against Very Severe Rotavirus Disease Through the Second Year of Life, Bolivia 2013-2014. Clin Infect Dis. 2016 May 1;62 Suppl 2:S115-20. PubMed PMID: 27059344.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sustained Effectiveness of Rotavirus Vaccine Against Very Severe Rotavirus Disease Through the Second Year of Life, Bolivia 2013-2014. AU - Pringle,Kimberly D, AU - Patzi,Maritza, AU - Tate,Jacqueline E, AU - Iniguez Rojas,Volga, AU - Patel,Manish, AU - Inchauste Jordan,Lucia, AU - Montesano,Raul, AU - Zarate,Adolfo, AU - De Oliveira,Lucia, AU - Parashar,Umesh, PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/29/medline KW - childhood mortality KW - diarrhea KW - gastroenteritis KW - middle-income country KW - rotavirus SP - S115 EP - 20 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 Suppl 2 N2 - BACKGROUND: In Bolivia, monovalent rotavirus vaccine was introduced in 2008 and a previous evaluation reported a vaccine effectiveness (VE) of 77% with 2 doses of vaccine in children aged <3 years. This evaluation sought to determine if rotavirus vaccine provided protection through the second year of life against circulating genotypes. METHODS: A case-control study was performed in 5 hospitals from April 2013 to March 2014. Among enrolled participants who met study criteria and had rotavirus stool testing performed and vaccine status confirmed, we calculated VE using a logistic regression model. Subgroup analyses were performed among children aged <1 year and those aged ≥1 year, among children with severe diarrhea (Vesikari score ≥11) and very severe diarrhea (Vesikari score ≥15), and among G and P strains with at least 40 specimens. RESULTS: A total of 776 children were enrolled. For children <1 year and ≥1 year of age with severe diarrhea, VE for 2 doses was 75% (95% confidence interval [CI], 46%-88%) and 53% (95% CI, 9%-76%), respectively. For children <1 year and ≥1 year of age with very severe diarrhea, VE for 2 doses was 80% (95% CI, 44%-93%) and 74% (95% CI, 35%-90%), respectively. Genotype-specific analysis demonstrated similar VE for the 4 most common G and P types (G3, G9, P[6] and P[8]). CONCLUSIONS: A monovalent rotavirus vaccine remains effective against a broad range of circulating strains as part of a routine immunization program >5 years after its introduction in Bolivia. Although VE appears to wane in children aged ≥1 year, it still provides significant protection, and does not wane against severe disease. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27059344/Sustained_Effectiveness_of_Rotavirus_Vaccine_Against_Very_Severe_Rotavirus_Disease_Through_the_Second_Year_of_Life_Bolivia_2013_2014_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ1026 DB - PRIME DP - Unbound Medicine ER -