Lack of nonspecific protection against all-cause nonrotavirus gastroenteritis by vaccination with orally administered rotavirus vaccine.
OBJECTIVE
Acute gastroenteritis (AGE) is recognized as a global, common threat to child survival, especially in developing countries. Rotavirus, in particular, has been implicated as a leading cause of severe AGE; however, there are numerous other pathogens that also cause AGE. Several studies have demonstrated that oral vaccination against rotavirus has generated the unanticipated benefit of protecting against AGE caused by nonrotavirus pathogens.


METHODS
Safety and efficacy of the pentavalent bovine-human reassortant rotavirus vaccine were studied in multiple populations, including children of the Navajo and White Mountain Apache tribes in the southwestern United States. Stool specimens were collected from children with AGE and tested for rotavirus using an enzyme immunoassay. Analyses were conducted to detect the presence or absence of a vaccine effect on incidence, severity, and duration of AGE in which rotavirus was not detected.


RESULTS
The majority of AGE (N = 558: 472 nonrotavirus vs 86 rotavirus) occurred between August 2002 and March 2004 among children ranging from ages 4 to 23 months. The incidence of nonrotavirus AGE was similar by vaccine groups with an incidence rate ratio of 1.07 (incidence rate ratio = vaccinated/unvaccinated, 95% confidence interval 0.89-1.29). The hazards of first, second, third, or any AGE in which rotavirus was not detected differed little by vaccination status (P > 0.05). Duration of symptoms and severity of nonrotavirus AGE were similar by vaccine group.


CONCLUSIONS
There was no vaccine effect on frequency or severity of nonrotavirus AGE.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Baltimore, MD 21205, USA. lgrant@jhsph.edu
Lindsay
L
Grant
James
J
Watt
Lawrence
L
Moulton
Robert
R
Weatherholtz
Raymond
R
Reid
Mathuram
M
Santosham
Katherine
K
O'Brien
D000284:Administration, Oral; D056738:Cross Protection; D005243:Feces / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D005759:Gastroenteritis / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D006801:Humans; D064789:Immunity, Heterologous; D015994:Incidence; D007198:Indians, North American; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000009:adverse effects; D012401:Rotavirus / Q000276:immunology* / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D015206:Southwestern United States; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use; D014777:Virus Diseases / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D014780:Viruses / Q000276:immunology / Q000302:isolation & purification
C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated