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Published on: January 28, 2019
Sustained Effectiveness of Monovalent and Pentavalent Rotavirus Vaccines in Children
Lilly Cheng Immergluck1, Trisha Chan Parker2, Shabnam Jain3
1Departments of Microbiology, Biochemistry, Immunology, and Pediatrics, Morehouse School of Medicine, Atlanta, GA; Clinical Research Center, Morehouse School of Medicine, Atlanta, GA; Children's Healthcare of Atlanta, Atlanta, GA.
Insights
Both the 2-dose monovalent rotavirus vaccine (RV1) and 3-dose pentavalent rotavirus vaccine (RV5) effectively protected infants against severe rotavirus disease. These vaccines provided sustained protection beyond two years of age.
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health
Background:
- Rotavirus is a leading cause of severe diarrheal disease in infants globally.
- Rotavirus vaccines are critical tools for preventing severe rotavirus gastroenteritis.
- Understanding vaccine effectiveness (VE) in real-world settings is essential for public health policy.
Purpose of the Study:
- To evaluate the vaccine effectiveness of the 2-dose monovalent rotavirus vaccine (RV1) and 3-dose pentavalent rotavirus vaccine (RV5) series.
- To assess VE against rotavirus disease requiring hospital emergency department or inpatient care.
- To determine if protection is sustained beyond infancy.
Main Methods:
- A case-control study was conducted with children presenting with diarrhea.
- Rotavirus antigen testing was performed on stool samples.
- Immunization records were cross-referenced to determine vaccination status.
Main Results:
- The study enrolled 98 rotavirus-positive cases and 175 rotavirus-negative controls.
- The G12P[8] genotype was predominant during the study period.
- The VE of 2 RV1 doses was 84% (8-23 months) and 82% (≥24 months).
- The VE of 3 RV5 doses was 80% (8-23 months) and 87% (≥24 months).
Conclusions:
- Both RV1 and RV5 vaccine series demonstrated significant effectiveness against moderate-to-severe rotavirus disease during a G12P[8] predominant season.
- The vaccines provided sustained protection beyond the first two years of life.
- Routine use of these rotavirus vaccines is effective in preventing severe disease.
Objective:
Using case-control methodology, we measured the vaccine effectiveness (VE) of the 2-dose monovalent rotavirus vaccine (RV1) and 3-dose pentavalent rotavirus vaccine (RV5) series given in infancy against rotavirus disease resulting in hospital emergency department or inpatient care.
Study Design:
Children were eligible for enrollment if they presented to any 1 of 3 hospitals in Atlanta, Georgia with diarrhea ≤10 days duration during January-June 2013 and were born after RV1 introduction. Stool samples were tested for rotavirus by enzyme immunoassay and immunization records were obtained from providers and the state electronic immunization information system. Case-subjects (children testing rotavirus antigen-positive) were compared with children testing rotavirus antigen-negative.
Results:
Overall, 98 rotavirus-case subjects and 175 rotavirus-negative controls were enrolled. Genotype G12P[8] predominated (n = 87, 89%). The VE of 2 RV1 doses was 84% (95% CI 38, 96) among children aged 8-23 months and 82% (95% CI 41, 95) among children aged ≥24 months. For the same age groups, the VE of 3 RV5 doses was 80% (95% CI 27, 95) and 87% (95% CI 22, 98), respectively.
Conclusions:
Under routine use, the RV1 and RV5 series were both effective against moderate-to-severe rotavirus disease during a G12P[8] season, and both vaccines demonstrated sustained protection beyond the first 2 years of life.
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