title: Case control study of rotavirus vaccine effectiveness in Portugal during 6 years of private market use.
abstract: BACKGROUND
  Although recommended by the vaccine committee of the Portuguese Paediatric Society, rotavirus vaccines have not been included in the routine immunization schedule. They have been available privately since 2006 with estimated coverage reaching approximately 30%. However, unlike other European countries using the vaccine, sentinel surveillance has detected fluctuations but no clear trends in the rate of gastrointestinal disease presentations. In this study, we set out to establish the real world effectiveness of rotavirus immunization in this low vaccine coverage setting.
  
  
  METHODS
  We carried out a test-negative case control study on a population of children attending a regional pediatric hospital, between 2006 and 2012, with symptoms of acute gastroenteritis and producing a stool sample for routine rotavirus testing. We calculated exposure odds ratio (ratio of odds of antecedent vaccination among cases compared with controls) to derive vaccine effectiveness ([1 - adjusted odds ratio]/100) against both hospital attendance and admission.
  
  
  RESULTS
  Vaccine effectiveness against attendance with rotavirus acute gastroenteritis was 83.7% (95% confidence interval: 73.9-89.8) and against hospital admission was 96.1% (95% confidence interval: 83.8-99.1). No significant difference between the 2 available vaccines was detected.
  
  
  CONCLUSIONS
  Both rotavirus vaccines offer a high degree of individual protection in this population.
authors.affiliation: From the *Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom; †Schools of Clinical Sciences & Cellular & Molecular Medicine, University of Bristol, United Kingdom; ‡Hospital Pediátrico de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; §Public Health Department, Administração Regional de Saúde do Centro, Coimbra, Portugal; ¶Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, United Kingdom; and ‖Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal.
authors.forename: Robin
authors.initials: R
authors.lastname: Marlow
authors.forename: Muriel
authors.initials: M
authors.lastname: Ferreira
authors.forename: Eugénio
authors.initials: E
authors.lastname: Cordeiro
authors.forename: Caroline
authors.initials: C
authors.lastname: Trotter
authors.forename: Luis
authors.initials: L
authors.lastname: Januário
authors.forename: Adam
authors.initials: A
authors.lastname: Finn
authors.forename: Fernanda
authors.initials: F
authors.lastname: Rodrigues
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011174:Portugal / Q000453:epidemiology; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022243:Rotavirus Vaccines