Effectiveness of pentavalent rotavirus vaccine in a large urban population in the United States.
OBJECTIVE
The goal was to assess the effectiveness of complete (3-dose) or partial (1- or 2-dose) immunization with pentavalent rotavirus vaccine (RV5) against rotavirus acute gastroenteritis (AGE) in US clinical practice.


METHODS
A case-control evaluation was conducted in February through June 2008 at an emergency department in Houston, Texas. Case patients with rotavirus AGE (N = 90) were identified through testing for rotavirus in fecal specimens obtained from 205 children 15 days through 23 months of age presenting with AGE. Control groups included rotavirus-negative AGE patients (N = 115), concurrently enrolled patients with acute respiratory infection (ARI) (N = 228), and up to 10 age- and zip code-matched children sampled from the Houston-Harris County Immunization Registry (HHCIR) for each case patient >8 months of age. Immunization data were obtained from parent records, health care providers, and/or the HHCIR. Vaccine effectiveness was calculated as 1 minus odds of RV5 vaccination for case patients versus control patients, after adjustment for age at presentation and birth date.


RESULTS
The vaccine effectiveness of a complete RV5 series was 89% (95% confidence interval [CI]: 70%-96%) and 85% (95% CI: 55%-95%) with rotavirus-negative AGE and ARI control patients, respectively. Immunization data were available for 44% of case patients (n = 40) from the HHCIR; the estimated 3-dose vaccine effectiveness with these HHCIR control patients was 82% (95% CI: 19%-96%). A complete RV5 series conferred 100% protection (95% CI: 71%-100%) against severe rotavirus disease requiring hospitalization and 96% protection (95% CI: 72%-99%) against disease requiring intravenous hydration. Vaccine effectiveness of 1 and 2 doses against hospitalization and emergency department visits was 69% (95% CI: 13%-89%) and 81% (95% CI: 13%-96%), respectively, using rotavirus-negative AGE and ARI control groups combined.


CONCLUSIONS
In this setting, a complete series of RV5 was highly effective against severe rotavirus AGE. Partial immunization also conferred substantial protection.
Boom
Julie A
JA
Baylor College of Medicine, Center for Vaccine Awareness and Research, Texas Children's Hospital, 6701 Fannin St, CC1540, Houston, TX 77030, USA. jboom@bcm.edu
Tate
Jacqueline E
JE
Sahni
Leila C
LC
Rench
Marcia A
MA
Hull
Jennifer J
JJ
Gentsch
Jon R
JR
Patel
Manish M
MM
Baker
Carol J
CJ
Parashar
Umesh D
UD
D017677:Age Distribution; D016022:Case-Control Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control / Q000821:virology*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011358:Product Surveillance, Postmarketing; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D013781:Texas / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D014613:Vaccines, Attenuated / Q000008:administration & dosage
C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated