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Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala.
Clin Infect Dis. 2016 May 01; 62 Suppl 2:S121-6.CI

Abstract

BACKGROUND

Concerns remain about lower effectiveness and waning immunity of rotavirus vaccines in resource-poor populations. We assessed vaccine effectiveness against rotavirus in Guatemala, where both the monovalent (RV1; 2-dose series) and pentavalent (RV5; 3-dose series) vaccines were introduced in 2010.

METHODS

A case-control evaluation was conducted in 4 hospitals from January 2012 to August 2013. Vaccine status was compared between case patients (children with laboratory-confirmed rotavirus diarrhea) and 2 sets of controls: nondiarrhea "hospital" controls (matched by birth date and site) and nonrotavirus "test-negative" diarrhea controls (adjusted for age, birth month/year, and site). Vaccine effectiveness ([1 - odds ratio of vaccination] × 100%) was computed using logistic regression models.

RESULTS

We evaluated 213 case patients, 657 hospital controls, and 334 test-negative controls. Effectiveness of 2-3 doses of a rotavirus vaccine against rotavirus requiring emergency department visit or hospitalization was 74% (95% confidence interval [CI], 58%-84%) with hospital controls, and 52% (95% CI, 26%-69%) with test-negative controls. Using hospital controls, no significant difference in effectiveness was observed between infants 6-11 months (74% [95% CI, 18%-92%]) and children ≥12 months of age (71% [95% CI, 44%-85%]) (P= .85), nor between complete courses of RV1 (63% [95% CI, 23%-82%]) and RV5 (69% [95% CI, 29%-87%]) (P= .96). An uncommon G12P[8] strain, partially heterotypic to strains in both vaccines, was identified in 89% of cases.

CONCLUSIONS

RV1 and RV5 were similarly effective against severe rotavirus diarrhea caused by a heterotypic strain in Guatemala. This supports broader implementation of rotavirus vaccination in low-income countries where >90% global deaths from rotavirus occur.

Authors+Show Affiliations

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Center for Health Studies, Universidad del Valle de Guatemala.Center for Health Studies, Universidad del Valle de Guatemala.Center for Health Studies, Universidad del Valle de Guatemala.International Emerging Infections Program, Centers for Disease Control and Prevention, Guatemala City.Center for Health Studies, Universidad del Valle de Guatemala.Center for Health Studies, Universidad del Valle de Guatemala.Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia West African Center for Cell Biology of Infectious Pathogens, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon.National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.Center for Health Studies, Universidad del Valle de Guatemala.

Pub Type(s)

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

Language

eng

PubMed ID

27059345

Citation

Gastañaduy, Paul A., et al. "Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62 Suppl 2, 2016, pp. S121-6.
Gastañaduy PA, Contreras-Roldán I, Bernart C, et al. Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala. Clin Infect Dis. 2016;62 Suppl 2:S121-6.
Gastañaduy, P. A., Contreras-Roldán, I., Bernart, C., López, B., Benoit, S. R., Xuya, M., Muñoz, F., Desai, R., Quaye, O., Tam, K. I., Evans-Bowen, D. K., Parashar, U. D., Patel, M., & McCracken, J. P. (2016). Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62 Suppl 2, S121-6. https://doi.org/10.1093/cid/civ1208
Gastañaduy PA, et al. Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala. Clin Infect Dis. 2016 May 1;62 Suppl 2:S121-6. PubMed PMID: 27059345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Guatemala. AU - Gastañaduy,Paul A, AU - Contreras-Roldán,Ingrid, AU - Bernart,Chris, AU - López,Beatriz, AU - Benoit,Stephen R, AU - Xuya,Marvin, AU - Muñoz,Fredy, AU - Desai,Rishi, AU - Quaye,Osbourne, AU - Tam,Ka Ian, AU - Evans-Bowen,Diana K, AU - Parashar,Umesh D, AU - Patel,Manish, AU - McCracken,John P, PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/29/medline KW - Guatemala KW - gastroenteritis KW - rotavirus KW - vaccine effectiveness SP - S121 EP - 6 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 Suppl 2 N2 - BACKGROUND: Concerns remain about lower effectiveness and waning immunity of rotavirus vaccines in resource-poor populations. We assessed vaccine effectiveness against rotavirus in Guatemala, where both the monovalent (RV1; 2-dose series) and pentavalent (RV5; 3-dose series) vaccines were introduced in 2010. METHODS: A case-control evaluation was conducted in 4 hospitals from January 2012 to August 2013. Vaccine status was compared between case patients (children with laboratory-confirmed rotavirus diarrhea) and 2 sets of controls: nondiarrhea "hospital" controls (matched by birth date and site) and nonrotavirus "test-negative" diarrhea controls (adjusted for age, birth month/year, and site). Vaccine effectiveness ([1 - odds ratio of vaccination] × 100%) was computed using logistic regression models. RESULTS: We evaluated 213 case patients, 657 hospital controls, and 334 test-negative controls. Effectiveness of 2-3 doses of a rotavirus vaccine against rotavirus requiring emergency department visit or hospitalization was 74% (95% confidence interval [CI], 58%-84%) with hospital controls, and 52% (95% CI, 26%-69%) with test-negative controls. Using hospital controls, no significant difference in effectiveness was observed between infants 6-11 months (74% [95% CI, 18%-92%]) and children ≥12 months of age (71% [95% CI, 44%-85%]) (P= .85), nor between complete courses of RV1 (63% [95% CI, 23%-82%]) and RV5 (69% [95% CI, 29%-87%]) (P= .96). An uncommon G12P[8] strain, partially heterotypic to strains in both vaccines, was identified in 89% of cases. CONCLUSIONS: RV1 and RV5 were similarly effective against severe rotavirus diarrhea caused by a heterotypic strain in Guatemala. This supports broader implementation of rotavirus vaccination in low-income countries where >90% global deaths from rotavirus occur. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27059345/Effectiveness_of_Monovalent_and_Pentavalent_Rotavirus_Vaccines_in_Guatemala_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ1208 DB - PRIME DP - Unbound Medicine ER -