title: Effectiveness of pentavalent and monovalent rotavirus vaccines in concurrent use among US children <5 years of age, 2009-2011.
abstract: BACKGROUND
  We assessed vaccine effectiveness (VE) for RotaTeq (RV5; 3 doses) and Rotarix (RV1; 2 doses) at reducing rotavirus acute gastroenteritis (AGE) inpatient and emergency department (ED) visits in US children.
  
  
  METHODS
  We enrolled children <5 years of age hospitalized or visiting the ED with AGE symptoms from November 2009-June 2010 and from November 2010-June 2011 at 7 medical institutions. Fecal specimens were tested for rotavirus by enzyme immunoassay and genotyped. Vaccination among laboratory-confirmed rotavirus cases was compared with rotavirus-negative AGE controls. Regression models calculated VE estimates for each vaccine, age, ethnicity, genotype, and clinical setting.
  
  
  RESULTS
  RV5-specific analyses included 359 rotavirus cases and 1811 rotavirus-negative AGE controls. RV1-specific analyses included 60 rotavirus cases and 155 rotavirus-negative AGE controls. RV5 and RV1 were 84% (95% confidence interval [CI], 78%-88%) and 70% (95% CI, 39%-86%) effective, respectively, against rotavirus-associated ED visits and hospitalizations combined. By clinical setting, RV5 VE against ED and inpatient rotavirus-associated visits was 81% (95% CI, 70%-84%) and 86% (95% CI, 74%-91%), respectively. RV1 was 78% (95% CI, 46%-91%) effective against ED rotavirus disease; study power was insufficient to evaluate inpatient RV1 VE. No waning of immunity was evident during the first 4 years of life for RV5, nor during the first 2 years of life for RV1. RV5 provided genotype-specific protection against each of the predominant strains (G1P[8], G2P[4], G3P[8], G12P[8]), while RV1 VE was statistically significant for the most common genotype, G3P[8].
  
  
  CONCLUSIONS
  Both RV5 and RV1 significantly protected against medically attended rotavirus gastroenteritis in this real-world assessment.
authors.affiliation: Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. dvp6@cdc.gov
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Payne
authors.forename: Julie A
authors.initials: JA
authors.lastname: Boom
authors.forename: Mary Allen
authors.initials: MA
authors.lastname: Staat
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.forename: Eileen J
authors.initials: EJ
authors.lastname: Klein
authors.forename: Rangaraj
authors.initials: R
authors.lastname: Selvarangan
authors.forename: Parvin H
authors.initials: PH
authors.lastname: Azimi
authors.forename: Christopher
authors.initials: C
authors.lastname: Harrison
authors.forename: Mary
authors.initials: M
authors.lastname: Moffatt
authors.forename: Samantha H
authors.initials: SH
authors.lastname: Johnston
authors.forename: Leila C
authors.initials: LC
authors.lastname: Sahni
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Baker
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Rench
authors.forename: Stephanie
authors.initials: S
authors.lastname: Donauer
authors.forename: Monica
authors.initials: M
authors.lastname: McNeal
authors.forename: James
authors.initials: J
authors.lastname: Chappell
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Weinberg
authors.forename: Azadeh
authors.initials: A
authors.lastname: Tasslimi
authors.forename: Jacqueline E
authors.initials: JE
authors.lastname: Tate
authors.forename: Mary
authors.initials: M
authors.lastname: Wikswo
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Curns
authors.forename: Iddrisu
authors.initials: I
authors.lastname: Sulemana
authors.forename: Slavica
authors.initials: S
authors.lastname: Mijatovic-Rustempasic
authors.forename: Mathew D
authors.initials: MD
authors.lastname: Esona
authors.forename: Michael D
authors.initials: MD
authors.lastname: Bowen
authors.forename: Jon R
authors.initials: JR
authors.lastname: Gentsch
authors.forename: Umesh D
authors.initials: UD
authors.lastname: Parashar
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000517:prevention & control; D005838:Genotype; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D014481:United States; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000276:immunology
chemical_list: C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: New Vaccine Surveillance Network; RotaTeq; rotavirus; vaccine