Yhu-Chering Huang1, Fang-Tzy Wu2, Yi-Chuan Huang3, Ching-Chun Liu4, Hsiao-Chuan Lin5, Hsin Chi6, Li-Min Huang7, Yu-Huai Ho8, Jian-Te Lee9, Shu-Man Shih10, Chao A Hsiung11. 1. Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan City, Taiwan. Electronic address: ychuang@adm.cgmh.org.tw. 2. Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Taipei City, Taiwan. 3. Department of Pediatrics, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung City, Taiwan. 4. Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan. 5. Division of Infectious Diseases, Children's Hospital, China Medical University, College of Medicine, Taichung, Taiwan. 6. Department of Pediatrics, Mackay Children's Hospital, Mackay Memorial Hospital, Taipei City, Taiwan. 7. Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University Hospital and Medical College, Taipei City, Taiwan. 8. Division of Infectious Disease, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan. 9. Department of Pediatrics, National Taiwan University Hospital at Yun-Lin, Yun-Lin, Taiwan. 10. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. 11. Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan. Electronic address: hsiung@nhri.org.tw.
Abstract
BACKGROUND: Two rotavirus vaccines (RV1 and RV5) are available on the private market in Taiwan, not included in national immunization program. Scanty reports evaluated the rotavirus vaccine effectiveness (VE) in Asian countries. METHODS: From February 2014-July 2017, we conducted a prospective case-control study in ten hospitals in Taiwan. Case-patients included children aged 8-59 months, and hospitalized with laboratory-confirmed rotavirus acute gastroenteritis (AGE). For each case patient, up to four controls, rotavirus-negative AGE or non-AGE illnesses, respectively, were matched by gender, age and enrolled date. Vaccination history was confirmed through vaccination card or hospital record. VE was calculated as (1 - odds ratio of vaccination) × 100%. RESULTS: Totally 4248 AGE patients and 2242 non-AGE controls were enrolled. A total of 330 case-patients with rotavirus AGE, 1226 rotavirus-negative AGE controls and 1122 non-AGE controls were included for analysis. Unvaccinated rate was 85.15% for rotavirus-positive cases, 42.9% for rotavirus-negative controls, and 34.31% for non-AGE controls. VE of two-dose RV1 was 84.9% (95% confidence interval [CI]:77.7%, 90.1%) for rotavirus-negative AGE and 88.9% (95% CI: 83.4%, 92.8%) for non-AGE controls, while VE of three-dose RV5 was 92.5% (95% CI: 85.1%, 96.7%) and 96.4% (95% CI: 91.9%, 98.6%), respectively. For respective vaccine, VEs were not significantly different in term of rotavirus genotypes. VEs of both vaccines declined <80% in children aged three years by combined controls. CONCLUSIONS: Both vaccines provided excellent and sustained protection against rotavirus AGE hospitalization in children in Taiwan, but the effectiveness declined slightly in children aged three years.
BACKGROUND: Two rotavirus vaccines (RV1 and RV5) are available on the private market in Taiwan, not included in national immunization program. Scanty reports evaluated the rotavirus vaccine effectiveness (VE) in Asian countries. METHODS: From February 2014-July 2017, we conducted a prospective case-control study in ten hospitals in Taiwan. Case-patients included children aged 8-59 months, and hospitalized with laboratory-confirmed rotavirus acute gastroenteritis (AGE). For each case patient, up to four controls, rotavirus-negative AGE or non-AGE illnesses, respectively, were matched by gender, age and enrolled date. Vaccination history was confirmed through vaccination card or hospital record. VE was calculated as (1 - odds ratio of vaccination) × 100%. RESULTS: Totally 4248 AGE patients and 2242 non-AGE controls were enrolled. A total of 330 case-patients with rotavirus AGE, 1226 rotavirus-negative AGE controls and 1122 non-AGE controls were included for analysis. Unvaccinated rate was 85.15% for rotavirus-positive cases, 42.9% for rotavirus-negative controls, and 34.31% for non-AGE controls. VE of two-dose RV1 was 84.9% (95% confidence interval [CI]:77.7%, 90.1%) for rotavirus-negative AGE and 88.9% (95% CI: 83.4%, 92.8%) for non-AGE controls, while VE of three-dose RV5 was 92.5% (95% CI: 85.1%, 96.7%) and 96.4% (95% CI: 91.9%, 98.6%), respectively. For respective vaccine, VEs were not significantly different in term of rotavirus genotypes. VEs of both vaccines declined <80% in children aged three years by combined controls. CONCLUSIONS: Both vaccines provided excellent and sustained protection against rotavirus AGE hospitalization in children in Taiwan, but the effectiveness declined slightly in children aged three years.