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Effectiveness of pentavalent and monovalent rotavirus vaccines in concurrent use among US children <5 years of age, 2009-2011.

Payne, Daniel C; Boom, Julie A; Staat, Mary Allen; Edwards, Kathryn M; Szilagyi, Peter G; Klein, Eileen J; Selvarangan, Rangaraj; Azimi, Parvin H; Harrison, Christopher; Moffatt, Mary; Johnston, Samantha H; Sahni, Leila C; Baker, Carol J; Rench, Marcia A; Donauer, Stephanie; McNeal, Monica; Chappell, James; Weinberg, Geoffrey A; Tasslimi, Azadeh; Tate, Jacqueline E; Wikswo, Mary; Curns, Aaron T; Sulemana, Iddrisu; Mijatovic-Rustempasic, Slavica; Esona, Mathew D; Bowen, Michael D; Gentsch, Jon R; Parashar, Umesh D.
Clin Infect Dis; 57(1): 13-20, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23487388

BACKGROUND:

We assessed vaccine effectiveness (VE) for RotaTeq (RV5; 3 doses) and Rotarix (RV1; 2 doses) at reducing rotavirus acute gastroenteritis (AGE) inpatient and emergency department (ED) visits in US children.

METHODS:

We enrolled children <5 years of age hospitalized or visiting the ED with AGE symptoms from November 2009-June 2010 and from November 2010-June 2011 at 7 medical institutions. Fecal specimens were tested for rotavirus by enzyme immunoassay and genotyped. Vaccination among laboratory-confirmed rotavirus cases was compared with rotavirus-negative AGE controls. Regression models calculated VE estimates for each vaccine, age, ethnicity, genotype, and clinical setting.

RESULTS:

RV5-specific analyses included 359 rotavirus cases and 1811 rotavirus-negative AGE controls. RV1-specific analyses included 60 rotavirus cases and 155 rotavirus-negative AGE controls. RV5 and RV1 were 84% (95% confidence interval [CI], 78%-88%) and 70% (95% CI, 39%-86%) effective, respectively, against rotavirus-associated ED visits and hospitalizations combined. By clinical setting, RV5 VE against ED and inpatient rotavirus-associated visits was 81% (95% CI, 70%-84%) and 86% (95% CI, 74%-91%), respectively. RV1 was 78% (95% CI, 46%-91%) effective against ED rotavirus disease; study power was insufficient to evaluate inpatient RV1 VE. No waning of immunity was evident during the first 4 years of life for RV5, nor during the first 2 years of life for RV1. RV5 provided genotype-specific protection against each of the predominant strains (G1P[8], G2P[4], G3P[8], G12P[8]), while RV1 VE was statistically significant for the most common genotype, G3P[8].

CONCLUSIONS:

Both RV5 and RV1 significantly protected against medically attended rotavirus gastroenteritis in this real-world assessment.