title: Impact of rotavirus vaccination in regions with low and moderate vaccine uptake in Germany.
abstract: In Germany, routine RV-vaccination is not adopted into the national immunization schedule as of 2012. Because RV-vaccines were already on the market since 2006, in 2010 a moderate (58%) and low (22%) vaccine uptake was observed in the 5 eastern federal states (EFS) and the 11 western federal states (WFS), respectively. To assess the impact of RV-vaccination, we compared the incidence rates (IR) of RV-related hospitalizations before (2004‒2006) and in seasons after (2008/09-2010/11) RV-vaccine introduction in Germany by utilizing data from the national mandatory disease reporting system. In the EFS, the IR was significantly reduced in age-groups < 18 mo in 2008/09 and in age-groups < 24 mo in 2009/10-2010/11. In the WFS an IR-reduction was observed only in age-groups < 12 mo in 2008/09 and in age-groups < 18 mo in 2009/10-2010/11. Overall IR-reduction in age-groups < 24 mo comparing 2008-11 with 2004-06 was 36% and 25% in EFS and WFS, respectively. In addition, we computed IR-ratios (IRR) in the seasons after mid-2006 with negative binomial regression. The effect of vaccination was independent from the geographic region. Vaccination was associated with a significant reduction in RV-related hospitalizations in the age-groups 6-23 mo. Most prominently, vaccination of 50% of infants led to an estimated decrease in age group 6-11 mo by 42%. No significant reduction was observed in age-groups ≥ 24 mo. In conclusion, in the German setting with low to moderate vaccine uptake, RV-related hospitalization incidence decreased substantially depending on the achieved vaccination coverage, but only in the first two years of life.
authors.affiliation: Immunization Unit, Robert Koch Institute, Berlin, Germany. DudarevaS@rki.de
authors.forename: Sandra
authors.initials: S
authors.lastname: Dudareva-Vizule
authors.forename: Judith
authors.initials: J
authors.lastname: Koch
authors.forename: Matthias
authors.initials: M
authors.lastname: An der Heiden
authors.forename: Doris
authors.initials: D
authors.lastname: Oberle
authors.forename: Brigitte
authors.initials: B
authors.lastname: Keller-Stanislawski
authors.forename: Ole
authors.initials: O
authors.lastname: Wichmann
mesh_terms: D005260:Female; D005858:Germany; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D014611:Vaccination / Q000706:statistics & numerical data
chemical_list: D022243:Rotavirus Vaccines