title: Impact of rotavirus vaccination in Germany: rotavirus surveillance, hospitalization, side effects and comparison of vaccines.
abstract: BACKGROUND
  Although rotavirus (RV) vaccination was licensed in 2006, it was not included into the officially recommended German childhood vaccination schedule until 2013. Local differences in health policies in the past led to large differences in vaccination coverage rate among the federal states of Germany. This enables an ecologic study of RV vaccine effectiveness.
  
  
  METHODS
  We performed a population-based retrospective analysis of RV vaccination use, RV notification and hospitalization among 0 to 5-year-old children in Germany during 2006 to 2011/2012. We compared effectiveness of the 2 RV vaccines, Rotateq and Rotarix, in an ambulatory setting and analyzed potential side effects.
  
  
  RESULTS
  We observed a significant reduction in RV notifications since introduction of RV vaccination. In areas attaining vaccine coverage of 64%, RV-related hospital admissions of 0 and 1-year-old children decreased by 60% compared with 19% reduction in the low vaccination coverage area. Decrease in RV-related hospitalizations of 0 and 1-year-old children was specific and significantly associated with vaccination coverage of the individual federal state (P < 0.0001, r = -0.68). There was no overall increase in intussusception rate or Kawasaki disease-related hospital admissions since introduction of RV vaccination. The 2 licensed RV vaccines had similar effectiveness in the ambulatory setting.
  
  
  CONCLUSIONS
  Postmarketing data suggest that RV vaccination is efficient in reducing RV-related hospitalizations. There is no apparent difference in effectiveness for Rotarix and Rotateq.
authors.affiliation: From the *Department of Pediatrics, John Radcliffe Hospital, Oxford, United Kingdom; †University Hospital for Children and Adolescents, Martin Luther University, Halle; ‡Institute of Medical Statistics, Frankfurt/Main; §University Hospital for Children and Adolescents, University of Leipzig, Leipzig; ¶Dr von Hauner Children's Hospital, Ludwig Maximilian University of Munich, Munich, Germany; and ‖Translational Gastroenterology Unit, University of Oxford, Oxford, United Kingdom.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Uhlig
authors.forename: Karel
authors.initials: K
authors.lastname: Kostev
authors.forename: Volker
authors.initials: V
authors.lastname: Schuster
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.forename: Holm H
authors.initials: HH
authors.lastname: Uhlig
mesh_terms: D002675:Child, Preschool; D018563:Disease Notification / Q000706:statistics & numerical data; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D005858:Germany / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007443:Intussusception / Q000139:chemically induced; D009080:Mucocutaneous Lymph Node Syndrome / Q000139:chemically induced; D011159:Population Surveillance; D012189:Retrospective Studies; D012400:Rotavirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000009:adverse effects; D014611:Vaccination / Q000706:statistics & numerical data*; D014613:Vaccines, Attenuated / Q000009:adverse effects
chemical_list: C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated