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Published on: January 28, 2019
Pentavalent rotavirus vaccine effectiveness among children in Shenzhen, China: A population-based test-negative
Zian Lin1, Weiyi Cai2, Yanan Liu2
1Department of Pediatrics, Shenzhen Longhua District Maternity and Child Healthcare Hospital, Shenzhen 518000, Guangdong Province, China.
Insights
The pentavalent rotavirus vaccine (RV5) is 79.6% effective against rotavirus gastroenteritis in children under five during epidemics. A three-dose regimen is most effective for children under 36 months, reducing public health burdens.
Area of Science:
- Pediatrics
- Vaccinology
- Infectious Diseases
Background:
- China's Notifiable Disease Reporting System collects pediatric acute gastroenteritis data.
- Rotavirus gastroenteritis is a significant concern in young children.
- Evaluating vaccine effectiveness is crucial for public health interventions.
Purpose of the Study:
- To assess the effectiveness of the pentavalent rotavirus vaccine (RV5) against rotavirus gastroenteritis.
- To evaluate vaccine effectiveness in children under five years during seasonal epidemics.
- To determine dose-specific and age-stratified vaccine effectiveness.
Main Methods:
- A test-negative design was employed using laboratory data from diarrhea patients aged 2-59 months.
- Data were collected retrospectively in Longhua District, Shenzhen, China (January 2020 - March 2024).
- Unconditional logistic regression was used to calculate adjusted odds ratios and vaccine effectiveness, controlling for confounders.
Main Results:
- Overall RV5 vaccine effectiveness was 79.6% (95% CI: 68.9%-86.6%) against rotavirus gastroenteritis.
- Three doses showed the highest effectiveness (82.7%), compared to one (26.7%) or two doses (76.6%).
- Effectiveness was high in children aged 2-35 months (79.5%-83.8%) but lower in those aged 36-59 months (31.2%).
Conclusions:
- A three-dose pentavalent rotavirus vaccine regimen offers significant protection against rotavirus gastroenteritis in children under 36 months during epidemic seasons.
- The vaccine helps alleviate the burden of rotavirus gastroenteritis on public health systems.
- Continued vaccination efforts are recommended to maintain protection against rotavirus disease.
Background:
China's Notifiable Disease Reporting System comprehensively collects data on pediatric acute gastroenteritis cases from all levels of healthcare. This study evaluated the effectiveness of the pentavalent rotavirus vaccine against rotavirus gastroenteritis in children under five years of age during seasonal epidemic periods.
Methods:
Using a test-negative design, we analyzed laboratory data from diarrhea patients aged 2-59 months who sought medical care in Longhua District, Shenzhen, Guangdong Province, China between January 2020 and March 2024. Vaccination history and potential confounders, including sex, household registration status, prematurity, and birth weight, were collected retrospectively. Directed acyclic graphs were used to identify adjustment variables. Vaccine effectiveness was calculated as (1 - adjusted odds ratio) × 100% using unconditional logistic regression, comparing rotavirus-positive cases with rotavirus-negative controls.
Results:
The incidence of rotavirus gastroenteritis peaked and then progressively declined from January 2020 through March 2023, with no seasonal resurgence observed in the first quarter of 2023. Analysis of 928 epidemic-season cases (674 RV+; 254 RV-) revealed an overall pentavalent rotavirus (RV5) vaccine effectiveness of 79.6% (95% CI: 68.9%-86.6%). Dose-specific vaccine effectiveness varied substantially: 1 dose vaccine effectiveness registered at 26.7% (95% CI: -162.1%-79.5%), rising to 76.6% (95% CI: 46.2%-89.8%) for 2 doses, and reaching 82.7% (95% CI: 72.2%-89.2%) for 3 doses. Age-stratified analysis showed vaccine effectiveness of 79.5% (95% CI: 56.8%-90.3%) in children aged 2-11 months, 83.8% (95% CI: 66.4%-92.2%) for 12-23 months, and 79.6% (95% CI: 68.9%-86.6%) in those aged 24-35 months, while vaccine effectiveness was 31.2% (95% CI: -251.8%-86.5%) in children aged 36-59 months.
Conclusions:
A three-dose regimen of pentavalent rotavirus vaccine provides significant effectiveness against rotavirus gastroenteritis for children under 36 months of age during epidemic seasons, thereby alleviating the burden on public health systems.
