title: Sustained High Effectiveness of RotaTeq on Hospitalizations Attributable to Rotavirus-Associated Gastroenteritis During 4 Years in Finland.
abstract: CONCLUSIONS
  The effectiveness of pentavalent rotavirus vaccine against rotavirus-associated hospitalization was more than 90% 4 years after introduction into the national immunization program in Finland. A major impact on hospitalization for all-cause gastroenteritis was observed also.
  
  
  BACKGROUND
  Rotavirus vaccination with exclusive use of RotaTeq was added to the National Immunization Programme (NIP) of Finland in September 2009. The objective of our study was to estimate the effectiveness and impact of RotaTeq after 4 years of follow-up.
  
  
  METHODS
  Between 2009 and 2013, we conducted a prospective surveillance study of children aged <16 years with acute gastroenteritis (AGE) and admitted in 2 hospitals in Finland. Rotavirus and other gastroenteritis viruses were detected in stool samples by reverse-transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assays. The effectiveness of RotaTeq was investigated by using a case-control design; wild-type rotavirus-positive children were classified as "cases" and rotavirus-negative children as "controls." Hospital discharge records were used to estimate the impact of RotaTeq on rotavirus-associated AGE (RV-AGE) and all-cause AGE (AC-AGE) hospitalizations of age-eligible children in the NIP by comparing the prevaccination (2001-2006) and post-NIP seasons (2009-2013).
  
  
  RESULTS
  The crude estimate of the effectiveness of RotaTeq to prevent RV-AGE hospitalization in NIP age-eligible children was 94.4% (95% confidence interval, 79.8%-98.4%). No change in prevalent wild-type rotavirus genotypes was observed. Vaccine-derived rotaviruses were detected in 8% of the children with RV-AGE, with a probable causal association in 2 children. Hospital discharge records revealed that RV-AGE and AC-AGE hospitalizations in children aged <16 years decreased in the two post-NIP seasons by 79% and 58%, respectively, compared to those in the prevaccination seasons.
  
  
  CONCLUSIONS
  Over 4 years of follow-up, high rotavirus vaccine coverage in the NIP (>95%) has led to a major reduction in RV-AGE and AC-AGE hospitalizations without a resurgence of rotavirus activity. However, rotavirus continues to circulate in older unvaccinated children.
authors.affiliation: Vaccine Research Center, School of Medicine, University of Tampere.
authors.forename: Maria
authors.initials: M
authors.lastname: Hemming-Harlo
authors.affiliation: Vaccine Research Center, School of Medicine, University of Tampere.
authors.forename: Timo
authors.initials: T
authors.lastname: Vesikari
authors.affiliation: PEDEGO Research Unit, University of Oulu, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Uhari
authors.affiliation: PEDEGO Research Unit, University of Oulu, Finland.
authors.forename: Marjo
authors.initials: M
authors.lastname: Renko
authors.affiliation: Vaccine Research Center, School of Medicine, University of Tampere.
authors.forename: Marjo
authors.initials: M
authors.lastname: Salminen
authors.affiliation: Epidemiology Department, Sanofi Pasteur-MSD, Lyon.
authors.forename: Laurence
authors.initials: L
authors.lastname: Torcel-Pagnon
authors.affiliation: Epidemiology Department, Sanofi Pasteur-MSD, Lyon.
authors.forename: Susanne
authors.initials: S
authors.lastname: Hartwig
authors.affiliation: IRD UMR 216, Faculté de Pharmacie, Université Paris Descartes, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Simondon
authors.affiliation: Epidemiology Department, Sanofi Pasteur-MSD, Lyon.
authors.forename: Hélène
authors.initials: H
authors.lastname: Bricout
mesh_terms: D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005387:Finland / Q000453:epidemiology; D005759:Gastroenteritis / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011159:Population Surveillance; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012401:Rotavirus / Q000235:genetics; D012400:Rotavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000627:therapeutic use*; D012621:Seasons; D016896:Treatment Outcome; D014613:Vaccines, Attenuated / Q000627:therapeutic use
chemical_list: C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: RotaTeq; effectiveness; gastroenteritis; impact; rotavirus; vaccine