title: Effectiveness of rotavirus vaccines, licensed but not funded, against rotavirus hospitalizations in the Valencia Region, Spain.
abstract: BACKGROUND
  Although rotavirus vaccines have been licensed in Spain for over 8 years, they are not funded by its public health systems. The analysis of their effectiveness in the Valencia Region could better inform decisions about potential inclusion in the official immunization schedule. Our aim was to assess the effectiveness of Rotarix® (RV1) and RotaTeq® (RV5) against rotavirus hospitalizations.
  
  
  METHODS
  We conducted a retrospective cohort study using the region's health care databases, among resident children aged <3 years covered by the National Health System, during January 2007-June 2012. We compared two cohorts of vaccinated children: the first included children who received at least one dose of a rotavirus vaccine, and the second included children who were not vaccinated with rotavirus vaccines but received at least one dose of a pneumococcal vaccine, another licensed but non-funded vaccine. The main outcome was rotavirus hospitalization, either laboratory-confirmed (confirmed) or codified as rotavirus (probable). Rotavirus vaccine effectiveness (RVE) by vaccine brand was assessed using Cox proportional hazards models.
  
  
  RESULTS
  The study included 78,281 rotavirus and 96,643 pneumococcal vaccinees. Adjusted RVE against probable or confirmed rotavirus hospitalizations was 86% (95% CI: 78-91%) and 88% (95% CI: 81-92%) for a complete series of RV1 and RV5 respectively.
  
  
  CONCLUSIONS
  Both rotavirus vaccines were over 85% effective against rotavirus hospitalization among young children. The high effectiveness shown argues in favor of their inclusion in the official schedule. Additional information on rotavirus vaccine safety, duration of protection, and benefit-risk will also be needed to inform such deliberations.
authors: Silvia
authors: S
authors: Pérez-Vilar
authors: Javier
authors: J
authors: Díez-Domingo
authors: Mónica
authors: M
authors: López-Lacort
authors: Sergio
authors: S
authors: Martínez-Úbeda
authors: Miguel A
authors: MA
authors: Martinez-Beneito
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D011008:Pneumococcal Infections / Q000517:prevention & control; D022242:Pneumococcal Vaccines / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012400:Rotavirus Infections / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000191:economics / Q000627:therapeutic use*; D013030:Spain; D016896:Treatment Outcome; D014613:Vaccines, Attenuated / Q000191:economics / Q000627:therapeutic use
chemical_list: D022242:Pneumococcal Vaccines; C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated