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Published on: January 28, 2019
Impact and Effectiveness of Monovalent Rotavirus Vaccine in Armenian Children
Gayane Sahakyan1, Svetlana Grigoryan2, Annemarie Wasley3
1National Immunization Program National Centre of Disease Control and Prevention Ministry of Health of the Republic of Armenia.
Insights
Rotavirus vaccine (RV1) significantly reduced hospitalizations in Armenian children by over 75% within three years. The vaccine demonstrated high effectiveness, offering substantial protection against severe rotavirus disease.
Area of Science:
- Immunology
- Pediatrics
- Public Health
Background:
- Armenia introduced the rotavirus vaccine (RV1) in 2012 to combat rotavirus disease, a major cause of acute gastroenteritis hospitalizations in children under 5.
- Rotavirus accounted for 38% of acute gastroenteritis hospitalizations in children under 5 years old.
Purpose of the Study:
- To assess the impact of rotavirus vaccine (RV1) introduction on rotavirus hospitalizations in Armenia.
- To estimate the vaccine effectiveness (VE) of RV1 against rotavirus hospitalizations in children.
Main Methods:
- Active surveillance of children under 5 hospitalized for acute gastroenteritis in Yerevan.
- Stool samples were tested for rotavirus antigen.
- Vaccine effectiveness was calculated using rotavirus-negative cases as controls.
Main Results:
- Rotavirus hospitalizations in infants decreased by 48% in the first year and over 75% in years 2 and 3 post-introduction.
- Overall rotavirus hospitalizations in children under 5 decreased by 69% in year 3, indicating indirect protection.
- The overall vaccine effectiveness (VE) of two RV1 doses was 62% against any severity rotavirus hospitalization and 79% against severe rotavirus disease.
Conclusions:
- The RV1 vaccine is highly effective in young Armenian children.
- RV1 substantially reduced rotavirus hospitalizations shortly after its introduction into the national immunization program.
Background:
The Republic of Armenia was 1 of the 2 earliest countries in the Newly Independent States to introduce rotavirus vaccine into its national immunization program to reduce the burden of rotavirus disease (documented to cause 38% of acute gastroenteritis hospitalizations [AGE] among children aged <5 years). In November 2012, RV1 (Rotarix) was introduced for Armenian infants at ages 6 and 12 weeks.
Methods:
The established active surveillance system at 2 hospitals in the capital, Yerevan, whereby children aged <5 years hospitalized for AGE have stool sample tested for rotavirus antigen, was used to assess trends in rotavirus hospitalizations. Immunization records on children enrolled after vaccine introduction were obtained from clinics, and vaccine effectiveness (VE) was estimated using children with AGE who test negative for rotavirus as controls for the rotavirus-positive cases.
Results:
Among infants, rotavirus hospitalizations were reduced by 48% within the first year after introduction, and by ≥75% in years 2 and 3 following introduction. Reductions of ≥30% in other young children too old to have been vaccinated suggest additional benefit through indirect protection; overall in year 3, rotavirus hospitalizations were reduced by 69% among children aged <5 years. The overall VE of 2 RV1 doses in protecting against rotavirus hospitalization (any severity) was 62% (95% confidence interval [CI], 36%-77%) among children aged 6-23 months; 68% (95% CI, 24%-86%) among those aged 6-11 months, and 60% (95% CI, 20%-80%) in children aged 12-23 months. Against more severe rotavirus disease, VE was 79% (95% CI, 55%-90%) and similarly high in both age groups.
Conclusions:
RV1 is effective in young Armenian children and substantially reduced rotavirus hospitalizations shortly after introduction.
