title: Duration of protection of pentavalent rotavirus vaccination in Nicaragua.
abstract: OBJECTIVE
  To evaluate the duration of protection of pentavaent rotavirus vaccine (RV5) against rotavirus hospitalizations in Nicaragua, a developing country in Central America.
  
  
  METHODS
  We conducted a case-control study at 4 hospitals from 2007 through 2010, including 1016 children hospitalized with laboratory-confirmed rotavirus diarrhea, 4930 controls with nonrotavirus diarrhea (ie, "test-negative"), and 5627 controls without diarrhea. All cases and controls were aged ≥ 6 months and born after August 2006. Outcomes included odds of antecedent vaccination between case-patients and controls, and effectiveness of vaccination (1 - adjusted odds ratio [OR] × 100). Duration of protection was assessed by comparing effectiveness among children aged <1 year compared with ≥ 1 year.
  
  
  RESULTS
  Indicators of socioeconomic conditions and nonrotavirus vaccination (oral polio vaccine and diphtheria/tetanus/pertussis/hepatitis A/hepatitis B) for test-negative controls were more comparable to the rotavirus case-patients than nondiarrhea controls. RV5 vaccination was associated with a significantly lower risk of rotavirus hospitalization by using test-negative controls (OR: 0.55; 95% confidence interval [CI]: 0.41-0.74) and nondiarrhea controls (OR: 0.30; 95% CI: 0.22-0.40). Risk of rotavirus hospitalization was twofold lower among RV5 vaccinated children aged <1 year (OR: 0.36; 95% CI: 0.22-0.57) compared with RV5 vaccinated children aged ≥ 1 year (OR: 0.70; 95% CI: 0.47-1.05).
  
  
  CONCLUSIONS
  RV5 provided good protection against severe rotavirus disease in Nicaragua during the first year of life, when most severe and fatal rotavirus disease in developing countries occurs. However, the decline in protection with age warrants monitoring of disease among older children and consideration of a booster dose evaluation at the end of infancy.
authors: Centers for Disease Control and Prevention, 1600 Clifton Rd, NE, Atlanta GA 30333, USA. aul3@cdc.gov
authors: Manish
authors: M
authors: Patel
authors: Cristina
authors: C
authors: Pedreira
authors: Lucia Helena
authors: LH
authors: De Oliveira
authors: Jazmina
authors: J
authors: Umaña
authors: Jacqueline
authors: J
authors: Tate
authors: Ben
authors: B
authors: Lopman
authors: Edmundo
authors: E
authors: Sanchez
authors: Martha
authors: M
authors: Reyes
authors: Juan
authors: J
authors: Mercado
authors: Alcides
authors: A
authors: Gonzalez
authors: Maria Celina
authors: MC
authors: Perez
authors: Angel
authors: A
authors: Balmaceda
authors: Jon
authors: J
authors: Andrus
authors: Umesh
authors: U
authors: Parashar
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D016022:Case-Control Studies; D003906:Developing Countries; D003968:Diarrhea, Infantile / Q000276:immunology* / Q000517:prevention & control*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007117:Immunization, Secondary; D007223:Infant; D008297:Male; D009527:Nicaragua; D016017:Odds Ratio; D011159:Population Surveillance; D012401:Rotavirus / Q000276:immunology*; D012400:Rotavirus Infections / Q000276:immunology* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000276:immunology*; D016896:Treatment Outcome; D014613:Vaccines, Attenuated / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated