title: Impact of rotavirus vaccination on childhood deaths from diarrhea in Brazil.
abstract: OBJECTIVE
  Rotavirus vaccination was introduced in Brazil in March 2006, targeting an annual birth cohort of approximately 3.5 million. We analyzed trends in all-cause gastroenteritis-related deaths in children <5 years of age during the pre- and post-vaccination periods.
  
  
  METHODS
  Data from the National Immunization Program and the Mortality Information System were used to calculate vaccine coverage and mortality rates related to gastroenteritis in children <1 year and 1-4 years of age, using population estimates from the census as the denominator. Relative reductions in mortality rates were calculated for 2007 and 2008, using the 2004-2005 mean as baseline before vaccine introduction.
  
  
  RESULTS
  Coverage of two doses of human rotavirus vaccine was 39% in 2006, increasing to 72% in 2007 and 77% in 2008. During 2004-2005, the gastroenteritis mortality rate in children <1 year of age was 56.9 per 100 000, decreasing by 30% (95% confidence interval (CI) 19-41) in 2007 and by 39% (95% CI 29-49) in 2008. In children 1-4 years of age, the mortality rate was 4.5 per 100 000 during 2004-2005, decreasing by 29% (95% CI 10-49) in 2007 and by 33% (95% CI 15-52) in 2008.
  
  
  CONCLUSIONS
  The decreased rates of childhood gastroenteritis-related deaths in Brazil following rotavirus vaccine introduction, particularly among children <1 year of age, suggest the potential benefit of vaccination.
authors.affiliation: GlaxoSmithKline Biologicals, Estrada dos Bandeirantes, 8464, Rio de Janeiro 22783-110, Brazil. tatiana.m.lanzieri@gmail.com
authors.forename: Tatiana M
authors.initials: TM
authors.lastname: Lanzieri
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Linhares
authors.forename: Iolanda
authors.initials: I
authors.lastname: Costa
authors.forename: Devayani A
authors.initials: DA
authors.lastname: Kolhe
authors.forename: Maria Helena
authors.initials: MH
authors.lastname: Cunha
authors.forename: Eduardo
authors.initials: E
authors.lastname: Ortega-Barria
authors.forename: Romulo E
authors.initials: RE
authors.lastname: Colindres
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D005759:Gastroenteritis / Q000401:mortality* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012400:Rotavirus Infections / Q000401:mortality* / Q000517:prevention & control; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D014611:Vaccination
chemical_list: D022243:Rotavirus Vaccines