Rotavirus vaccination in Brazil: effectiveness and health impact seven years post-introduction

Area of Science:

• Pediatric Infectious Diseases
• Vaccinology
• Public Health

Background:

• Rotavirus infection posed a significant burden in Brazil before vaccine introduction, causing substantial morbidity and mortality in children under 5.
• Brazil integrated rotavirus vaccination into its National Immunisation Program (NIP) in 2006, aiming to mitigate this burden.

Purpose of the Study:

• To review postlicensure studies on rotavirus vaccine effectiveness and impact in Brazil.
• To assess the vaccine's safety profile and epidemiological effects seven years after its introduction.

Main Methods:

• Review of postlicensure studies, including case-control and observational designs.
• Analysis of rotavirus gastroenteritis-related hospitalizations, deaths, and circulating strains.
• Evaluation of vaccine coverage and intussusception incidence.

Main Results:

• Rotavirus vaccination demonstrated high effectiveness (up to 85%) and significantly reduced hospitalizations (up to 48%) and deaths (up to 54%) in children under 1 year.
• A notable increase in the G2P[4] genotype prevalence was observed post-vaccination.
• A minor increase in intussusception risk was identified within a week of the second vaccine dose.

Conclusions:

• Rotavirus vaccination has proven highly beneficial in Brazil, with its advantages significantly outweighing potential risks.
• The vaccine program has successfully reduced the impact of rotavirus disease, contributing to child survival.
• Continued surveillance is essential to monitor vaccine impact and evolving rotavirus strains.