title: Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis.
abstract: BACKGROUND
  Rotavirus remains the leading cause of severe diarrhea in children under 5 years worldwide. In the US, Rotarix (RV1) and RotaTeq (RV5), have been associated with reductions in and severity of rotavirus disease. Studies have evaluated the impact of RV1 or RV5 but little is known about the impact of incomplete or mixed vaccination upon vaccine effectiveness.
  
  
  METHODS
  Case control study to examine association of combined RV1 and RV5 and rotavirus acute gastroenteritis, factoring severity of diarrheal disease. Children born after March 1, 2009 with acute gastroenteritis from three pediatric hospitals in Atlanta, Georgia were approached for enrollment. Survey was administered, stool specimen was collected, and vaccination records were obtained.
  
  
  RESULTS
  891 of 1127 children with acute gastroenteritis were enrolled. Stool specimens were collected from 708 for rotavirus testing; 215 stool samples tested positively for rotavirus. Children >12 months of age were more likely to have rotavirus. Children categorized with Vesikari score of >11 were almost twice as likely to be rotavirus positive. Prior rotavirus vaccination decreased the mean Vesikari score, p<0.0001. Children with complete single type vaccination were protected against rotavirus (OR 0.21, 95% CI: 0.14-0.31, p<0.0001).
  
  
  CONCLUSIONS
  Complete rotavirus vaccination with a single vaccine type resulted in protection against rotavirus diarrhea and decrease in severity of rotavirus gastroenteritis. Incomplete rotavirus vaccination either with a single vaccine or mixed vaccination types also provided some protection.
authors: Pediatric Emergency Medicine Associates, Atlanta, GA, USA.
authors: Anaam
authors: A
authors: Mohammed
authors: Morehouse School of Medicine, Departments of Microbiology/Biochemistry/Immunology and Pediatrics, Atlanta, GA, USA; Emory University, Department of Pediatrics, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA. Electronic address: limmergluck@msm.edu.
authors: Lilly
authors: L
authors: Immergluck
authors: Morehouse School of Medicine, Departments of Microbiology/Biochemistry/Immunology and Pediatrics, Atlanta, GA, USA.
authors: Trisha Chan
authors: TC
authors: Parker
authors: Emory University, Department of Pediatrics, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors: Shabnam
authors: S
authors: Jain
authors: Emory University, Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors: Traci
authors: T
authors: Leong
authors: Emory University, Department of Pediatrics, Atlanta, GA, USA; Emory University, Department of Medicine, Atlanta, GA, USA.
authors: Evan J
authors: EJ
authors: Anderson
authors: Emory University, Department of Pathology and Laboratory Medicine, Atlanta, GA, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors: Robert C
authors: RC
authors: Jerris
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D056738:Cross Protection; D003967:Diarrhea / Q000517:prevention & control / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000517:prevention & control / Q000821:virology*; D005845:Georgia; D006801:Humans; D007223:Infant; D008297:Male; D012401:Rotavirus; D012400:Rotavirus Infections / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D012720:Severity of Illness Index; D014611:Vaccination; D014613:Vaccines, Attenuated / Q000627:therapeutic use
chemical_list: C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: Acute gastroenteritis; Pediatric; Rotavirus; Rotavirus vaccination