Effectiveness of Monovalent and Pentavalent Rotavirus Vaccine
OBJECTIVE: Previous US evaluations have not assessed monovalent rotavirus vaccine (RV1, a G1P human rotavirus strain) effectiveness, because of its later introduction (2008). Using case-control methodology, we measured the vaccine effectiveness (VE) of the 2-dose RV1 and 3-dose pentavalent vaccine (RV5) series against rotavirus disease resulting in hospital emergency department or inpatient care.
METHODS: Children were eligible for enrollment if they presented to 1 of 5 hospitals (3 in Georgia, 2 in Connecticut) with diarrhea of ≤10 days’ duration during January through June 2010 or 2011, and were born after RV1 introduction. Stools were collected; immunization records were obtained from providers and state electronic immunization information system (IIS). Case-subjects (children testing rotavirus antigen-positive) were compared with 2 control groups: children testing rotavirus negative and children selected from IIS.
RESULTS: Overall, 165 rotavirus-case subjects and 428 rotavirus-negative controls were enrolled. Using the rotavirus-negative controls, RV1 VE was 91% (95% confidence interval [CI] 80 to 95) and RV5 VE was 92% (CI 75 to 97) among children aged ≥8 months. The RV1 VE against G2P disease was high (94%, CI 78 to 98), as was that against G1P disease (89%, CI 70 to 96). RV1 effectiveness was sustained among children aged 12 through 23 months (VE 91%; CI 75 to 96). VE point estimates using IIS controls were similar to those using rotavirus-negative controls.
CONCLUSIONS: RV1 and RV5 were both highly effective against severe rotavirus disease. RV1 conferred sustained protection during the first 2 years of life and demonstrated high effectiveness against G2P (heterotypic) disease.
- CI —
- confidence interval
- DTaP —
- diphtheria-tetanus-acellular pertussis
- ED —
- emergency department
- EIA —
- enzyme immunoassay
- IIS —
- immunization information system
- OR —
- odds ratio
- PCV —
- pneumococcal conjugate vaccine
- RV —
- rotavirus vaccine
- RV1 —
- monovalent rotavirus vaccine
- RV5 —
- pentavalent rotavirus vaccine
- VE —
- vaccine effectiveness
- Accepted April 12, 2013.
- Copyright © 2013 by the American Academy of Pediatrics