title: Case-control study of the effectiveness of vaccination with pentavalent rotavirus vaccine in Nicaragua.
abstract: BACKGROUND
  In 2006, Merck & Co., Inc., partnered with the Nicaraguan Ministry of Health to demonstrate the public health impact of routine universal vaccination by delivering more than 1.3 million doses of the oral, pentavalent rotavirus vaccine (RV5) in a 3-year period.
  
  
  METHODS
  A matched case-control study evaluated the effectiveness of RV5 in reducing the risk for severe wild-type rotavirus gastroenteritis (RGE) resulting in hospitalizations and emergency department visits among children who completed the recommended 3-dose regimen as part of the routine national vaccine program. Cases were identified from 6 hospitals from February 2007 to October 2009 and were age-matched with hospital controls and community controls. Vaccine effectiveness was calculated using conditional logistic regression.
  
  
  RESULTS
  Three hundred RGE cases eligible for analysis were matched to 792 hospital and 851 community controls. Vaccine coverage of RV5 in the community reached 92%. Vaccine effectiveness during 2 years of follow-up against severe disease in children receiving 3 doses of RV5 was 87% (95% confidence interval [CI], 74-93) for community controls, 64% (95% CI, 44-78) for hospital controls, and 76% (95% CI, 63-84) when the groups were combined. For the combined groups, vaccine effectiveness was 85% (95% CI, 66-93) among children <12 months old at the time of RGE onset.
  
  
  CONCLUSIONS
  The Merck-Nicaragua Rotavirus Vaccine Partnership promoted rapid and widespread uptake of a novel vaccine in a developing country. Vaccine effectiveness was greatest for children younger than 12 months of age who were at the highest risk for severe rotavirus disease.
authors.affiliation: Merck Research Laboratories, North Wales, PA 19486, USA. christopher_mast@merck.com
authors.forename: T Christopher
authors.initials: TC
authors.lastname: Mast
authors.forename: Shazia
authors.initials: S
authors.lastname: Khawaja
authors.forename: Félix
authors.initials: F
authors.lastname: Espinoza
authors.forename: Margarita
authors.initials: M
authors.lastname: Paniagua
authors.forename: Leonel Palacio
authors.initials: LP
authors.lastname: Del Carmen
authors.forename: Anna
authors.initials: A
authors.lastname: Cardellino
authors.forename: Edmundo
authors.initials: E
authors.lastname: Sánchez
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D003906:Developing Countries; D004345:Drug Industry / Q000191:economics / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009527:Nicaragua / Q000453:epidemiology; D011634:Public Health; D055818:Public-Private Sector Partnerships / Q000191:economics / Q000458:organization & administration; D012400:Rotavirus Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014611:Vaccination
chemical_list: D022243:Rotavirus Vaccines