title: Evaluating the first introduction of rotavirus vaccine in Thailand: Moving from evidence to policy.
abstract: We assessed the effectiveness and possible impact of introducing rotavirus vaccine into the routine immunization program.
  
  
  
  Two provinces were selected for an observational study, one where vaccine was introduced and another where vaccine was not available. In these areas, two sub-studies were linked. The prospective cohort study enrolled children 2month old and followed them to the age of 18months to detect all diarrhea episodes. The hospital surveillance study enrolled all children up to age 5 hospitalized with diarrhea whose fecal samples were tested for rotavirus. Rates of rotavirus hospitalizations in older children who had not been vaccinated in both settings provided data to determine whether immunization had an indirect herd effect. The key endpoints for the study were both vaccine effectiveness (VE) based upon hospitalized rotavirus diarrhea and herd protection.
  
  
  
  From the cohort study, the overall VE for hospitalized rotavirus diarrhea was 88% (95%CI 76-94). Data from hospital surveillance indicated that for 2 consecutive years, the seasonal peak of rotavirus admissions was no longer present in the vaccinated area. Herd protection was observed among older children born before the rotavirus vaccine program was introduced, who experienced a 40-69% reduction in admission for rotavirus.
  
  
  
  Rotavirus vaccine was highly effective in preventing diarrheal hospitalizations and in conferring herd protection among older children who had not been vaccinated.
authors.affiliation: Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand. Electronic address: piyanit@health.moph.go.th.
authors.forename: Piyanit
authors.initials: P
authors.lastname: Tharmaphornpilas
authors.affiliation: Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Suchada
authors.initials: S
authors.lastname: Jiamsiri
authors.affiliation: Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Somchit
authors.initials: S
authors.lastname: Boonchaiya
authors.affiliation: Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
authors.forename: Onwipa
authors.initials: O
authors.lastname: Rochanathimoke
authors.affiliation: Phetchabun Provincial Health Office, Phetchabun, Thailand.
authors.forename: Wiravan
authors.initials: W
authors.lastname: Thinyounyong
authors.affiliation: Sukhothai Provincial Health Office, Sukhothai, Thailand.
authors.forename: Sumana
authors.initials: S
authors.lastname: Tuntiwitayapun
authors.affiliation: Department of Medical Science, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Ratigorn
authors.initials: R
authors.lastname: Guntapong
authors.affiliation: Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
authors.forename: Arthorn
authors.initials: A
authors.lastname: Riewpaiboon
authors.affiliation: Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Aim-On
authors.initials: AO
authors.lastname: Rasdjarmrearnsook
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Roger I
authors.initials: RI
authors.lastname: Glass
mesh_terms: D002675:Child, Preschool; D003967:Diarrhea / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D032521:Immunity, Herd / Q000187:drug effects; D017589:Immunization Programs / Q000458:organization & administration*; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012401:Rotavirus / Q000187:drug effects* / Q000276:immunology; D012400:Rotavirus Infections / Q000276:immunology / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage*; D013785:Thailand; D014611:Vaccination; D064166:Vaccine Potency; D014613:Vaccines, Attenuated
chemical_list: D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: Rotavirus vaccine; Vaccine effectiveness; Vaccine impact