title: Effectiveness of rotavirus vaccine in preventing severe gastroenteritis in young children according to socioeconomic status.
abstract: In 2011, the monovalent rotavirus vaccine was introduced into a universal immunization program in Quebec (Canada). This retrospective cohort study assessed vaccine effectiveness (VE) in preventing acute gastroenteritis (AGE) and rotavirus gastroenteritis (RVGE) hospitalizations among children <3 y living in the Quebec Eastern Townships region according to socioeconomic status (SES). Data were gathered from a tertiary hospital database paired with a regional immunization registry. Three cohorts of children were followed: (1) vaccinated children born in post-universal vaccination period (2011-2013, n = 5,033), (2) unvaccinated children born in post-universal vaccination period (n = 1,239), and (3) unvaccinated children born in pre-universal vaccination period (2008-2010, n = 6,436). In each cohort, AGE and RVGE hospitalizations were identified during equivalent follow-up periods to calculate VE globally and according to neighborhood-level SES. Using multivariable logistic regression, adjusted odds ratios (OR) were computed to obtain VE (1-OR). Adjusted VE of 2 doses was 62% (95% confidence interval [CI]: 37%-77%) and 94% (95%CI: 52%-99%) in preventing AGE and RVGE hospitalization, respectively. Stratified analyses according to SES showed that children living in neighborhoods with higher rates of low-income families had significantly lower VE against AGE hospitalizations compared to neighborhoods with lower rates of low-income families (30% vs. 78%, p = 0.027). Our results suggest that the rotavirus vaccine is highly effective in preventing severe gastroenteritis in young children, particularly among the most well-off. SES seems to influence rotavirus VE, even in a high-income country like Canada. Further studies are needed to determine factors related to lower rotavirus VE among socioeconomically disadvantaged groups.
authors.affiliation: a Community Health Sciences Department , Faculty of Medicine and Health Sciences, University of Sherbrooke , Sherbrooke , Quebec , Canada.
authors.forename: Virginie
authors.initials: V
authors.lastname: Gosselin
authors.affiliation: a Community Health Sciences Department , Faculty of Medicine and Health Sciences, University of Sherbrooke , Sherbrooke , Quebec , Canada.|b Eastern Townships Public Health Department , Sherbrooke , Quebec , Canada.
authors.forename: Mélissa
authors.initials: M
authors.lastname: Généreux
authors.affiliation: c Pediatrics Department , Faculty of Medicine and Health Sciences, University of Sherbrooke , Sherbrooke , Quebec , Canada.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Gagneur
authors.affiliation: a Community Health Sciences Department , Faculty of Medicine and Health Sciences, University of Sherbrooke , Sherbrooke , Quebec , Canada.|b Eastern Townships Public Health Department , Sherbrooke , Quebec , Canada.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Petit
mesh_terms: D000328:Adult; D002675:Child, Preschool; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology* / Q000517:prevention & control*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012400:Rotavirus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D012923:Social Class; D055815:Young Adult
chemical_list: D022243:Rotavirus Vaccines
keywords: gastroenteritis; retrospective cohort study; rotavirus vaccines; socioeconomic; vaccine effectiveness