Piyanit Tharmaphornpilas1, Suchada Jiamsiri2, Somchit Boonchaiya2, Onwipa Rochanathimoke3, Wiravan Thinyounyong4, Sumana Tuntiwitayapun5, Ratigorn Guntapong6, Arthorn Riewpaiboon3, Aim-On Rasdjarmrearnsook2, Roger I Glass7. 1. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. Electronic address: piyanit@health.moph.go.th. 2. Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. 3. Faculty of Pharmacy, Mahidol University, Bangkok, Thailand. 4. Phetchabun Provincial Health Office, Phetchabun, Thailand. 5. Sukhothai Provincial Health Office, Sukhothai, Thailand. 6. Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand. 7. Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
Abstract
BACKGROUND: We assessed the effectiveness and possible impact of introducing rotavirus vaccine into the routine immunization program. METHODS: Two provinces were selected for an observational study, one where vaccine was introduced and another where vaccine was not available. In these areas, two sub-studies were linked. The prospective cohort study enrolled children 2month old and followed them to the age of 18months to detect all diarrhea episodes. The hospital surveillance study enrolled all children up to age 5 hospitalized with diarrhea whose fecal samples were tested for rotavirus. Rates of rotavirus hospitalizations in older children who had not been vaccinated in both settings provided data to determine whether immunization had an indirect herd effect. The key endpoints for the study were both vaccine effectiveness (VE) based upon hospitalized rotavirus diarrhea and herd protection. FINDINGS: From the cohort study, the overall VE for hospitalized rotavirus diarrhea was 88% (95%CI 76-94). Data from hospital surveillance indicated that for 2 consecutive years, the seasonal peak of rotavirus admissions was no longer present in the vaccinated area. Herd protection was observed among older children born before the rotavirus vaccine program was introduced, who experienced a 40-69% reduction in admission for rotavirus. CONCLUSIONS: Rotavirus vaccine was highly effective in preventing diarrheal hospitalizations and in conferring herd protection among older children who had not been vaccinated.
BACKGROUND: We assessed the effectiveness and possible impact of introducing rotavirus vaccine into the routine immunization program. METHODS: Two provinces were selected for an observational study, one where vaccine was introduced and another where vaccine was not available. In these areas, two sub-studies were linked. The prospective cohort study enrolled children 2month old and followed them to the age of 18months to detect all diarrhea episodes. The hospital surveillance study enrolled all children up to age 5 hospitalized with diarrhea whose fecal samples were tested for rotavirus. Rates of rotavirus hospitalizations in older children who had not been vaccinated in both settings provided data to determine whether immunization had an indirect herd effect. The key endpoints for the study were both vaccine effectiveness (VE) based upon hospitalized rotavirus diarrhea and herd protection. FINDINGS: From the cohort study, the overall VE for hospitalized rotavirus diarrhea was 88% (95%CI 76-94). Data from hospital surveillance indicated that for 2 consecutive years, the seasonal peak of rotavirus admissions was no longer present in the vaccinated area. Herd protection was observed among older children born before the rotavirus vaccine program was introduced, who experienced a 40-69% reduction in admission for rotavirus. CONCLUSIONS: Rotavirus vaccine was highly effective in preventing diarrheal hospitalizations and in conferring herd protection among older children who had not been vaccinated.
Authors: Eleanor Burnett; Jacqueline E Tate; Carl D Kirkwood; E Anthony S Nelson; Mathuram Santosham; A Duncan Steele; Umesh D Parashar Journal: Expert Rev Vaccines Date: 2018-02-26 Impact factor: 5.217
Authors: Adam W J Jenney; Rita Reyburn; Felisita T Ratu; Evelyn Tuivaga; Cattram Nguyen; Sokoveti Covea; Sarah Thomas; Eric Rafai; Rachel Devi; Kathryn Bright; Kylie Jenkins; Beth Temple; Lisi Tikoduadua; Joe Kado; E Kim Mulholland; Carl D Kirkwood; Kimberley K Fox; Julie E Bines; Varja Grabovac; Aalisha Sahu Khan; Mike Kama; Fiona M Russell Journal: Lancet Reg Health West Pac Date: 2020-11-25