title: Effectiveness of the monovalent G1P[8] human rotavirus vaccine against hospitalization for severe G2P[4] rotavirus gastroenteritis in Belém, Brazil.
abstract: BACKGROUND
  Brazil initiated universal immunization of infants with the G1P[8] human rotavirus (RV) vaccine in March 2006. This study evaluated vaccine effectiveness (VE) against severe rotavirus gastroenteritis (RVGE) hospitalizations.
  
  
  METHODS
  Matched case-control study conducted at 4 hospitals in Belém from May 2008 to May 2009. Cases were children hospitalized with RVGE age-eligible to have received 2 doses of the human RV vaccine (≥ 12 weeks of age and born after March 6, 2006). For each case, 1 neighborhood and 1 hospital control without gastroenteritis was selected, matching by birth date (± 8 and ± 6 weeks, respectively). Matched odds ratio of 2-dose RV vaccination in cases versus controls was used to estimate VE (1 - odds ratio × 100%).
  
  
  RESULTS
  Of 538 RVGE cases, 507 hospital controls and 346 neighborhood controls included, 54%, 61%, and 74% had received both RV vaccine doses. VE against RVGE hospitalization was 75.8% (95% confidence interval [CI]: 58.1-86.0) using neighborhood controls and 40.0% (95% CI: 14.2-58.1) using hospital controls. VE in children 3 to 11 months and ≥ 12 months of age was 95.7% (95% CI: 67.8-99.4) and 65.1% (95% CI: 37.2-80.6) using neighborhood controls, and 55.6% (95% CI: 12.3-77.5) and 32.1% (95% CI: -3.7-55.5) using hospital controls. G2P[4] accounted for 82.0% of RVGE hospitalizations. G2P[4]-specific VE was 75.4% (95% CI: 56.7-86.0) using neighborhood controls and 38.9% (95% CI: 11.1-58.0) using hospital controls.
  
  
  CONCLUSIONS
  Although fully heterotypic G2P[4] was the predominant RV strain, good VE was demonstrated. VE was highest in children aged 3 to 11 months. However, protection in children ≥ 12 months of age, important for optimal public health impact, was significantly sustained based on estimates obtained using neighborhood controls.
authors.affiliation: Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Belém, Brazil. alexandrelinhares@iec.pa.gov.br
authors.forename: Maria Cleonice A
authors.initials: MC
authors.lastname: Justino
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Linhares
authors.forename: Tatiana M
authors.initials: TM
authors.lastname: Lanzieri
authors.forename: Yllen
authors.initials: Y
authors.lastname: Miranda
authors.forename: Joana D'arc P
authors.initials: JD
authors.lastname: Mascarenhas
authors.forename: Erika
authors.initials: E
authors.lastname: Abreu
authors.forename: Sylvia F S
authors.initials: SF
authors.lastname: Guerra
authors.forename: Alessilva S L
authors.initials: AS
authors.lastname: Oliveira
authors.forename: Veronilce B
authors.initials: VB
authors.lastname: da Silva
authors.forename: Nervo
authors.initials: N
authors.lastname: Sanchez
authors.forename: Nadia
authors.initials: N
authors.lastname: Meyer
authors.forename: Fakrudeen
authors.initials: F
authors.lastname: Shafi
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ortega-Barria
authors.forename: Montse
authors.initials: M
authors.lastname: Soriano-Gabarró
authors.forename: Romulo E
authors.initials: RE
authors.lastname: Colindres
mesh_terms: D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control*; D005838:Genotype; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D012401:Rotavirus / Q000145:classification / Q000235:genetics / Q000276:immunology; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*
chemical_list: D022243:Rotavirus Vaccines