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Multicenter Study
. 2012 Aug 8:345:e4752.
doi: 10.1136/bmj.e4752.

Effectiveness of rotavirus vaccination in prevention of hospital admissions for rotavirus gastroenteritis among young children in Belgium: case-control study

Tessa Braeckman  1 , Koen Van Herck, Nadia Meyer, Jean-Yves Pirçon, Montse Soriano-Gabarró, Elisabeth Heylen, Mark Zeller, Myriam Azou, Heidi Capiau, Jan De Koster, Anne-Sophie Maernoudt, Marc Raes, Lutgard Verdonck, Marc Verghote, Anne Vergison, Jelle Matthijnssens, Marc Van Ranst, Pierre Van Damme; RotaBel Study Group
Collaborators, Affiliations
Multicenter Study

Effectiveness of rotavirus vaccination in prevention of hospital admissions for rotavirus gastroenteritis among young children in Belgium: case-control study

Tessa Braeckman et al. BMJ. .

Abstract

Objective: To evaluate the effectiveness of rotavirus vaccination among young children in Belgium.

Design: Prospective case-control study.

Setting: Random sample of 39 Belgian hospitals, February 2008 to June 2010.

Participants: 215 children admitted to hospital with rotavirus gastroenteritis confirmed by polymerase chain reaction and 276 age and hospital matched controls. All children were of an eligible age to have received rotavirus vaccination (that is, born after 1 October 2006 and aged ≥ 14 weeks).

Main outcome measure: Vaccination status of children admitted to hospital with rotavirus gastroenteritis and matched controls.

Results: 99 children (48%) admitted with rotavirus gastroenteritis and 244 (91%) controls had received at least one dose of any rotavirus vaccine (P<0.001). The monovalent rotavirus vaccine accounted for 92% (n=594) of all rotavirus vaccine doses. With hospital admission as the outcome, the unadjusted effectiveness of two doses of the monovalent rotavirus vaccine was 90% (95% confidence interval 81% to 95%) overall, 91% (75% to 97%) in children aged 3-11 months, and 90% (76% to 96%) in those aged ≥ 12 months. The G2P[4] genotype accounted for 52% of cases confirmed by polymerase chain reaction with eligible matched controls. Vaccine effectiveness was 85% (64% to 94%) against G2P[4] and 95% (78% to 99%) against G1P[8]. In 25% of cases confirmed by polymerase chain reaction with eligible matched controls, there was reported co-infection with adenovirus, astrovirus and/or norovirus. Vaccine effectiveness against co-infected cases was 86% (52% to 96%). Effectiveness of at least one dose of any rotavirus vaccine (intention to vaccinate analysis) was 91% (82% to 95%).

Conclusions: Rotavirus vaccination is effective for the prevention of admission to hospital for rotavirus gastroenteritis among young children in Belgium, despite the high prevalence of G2P[4] and viral co-infection.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Figures

None
Fig 1 Summary of enrolment by cohort. Screened cohort=all children aged ≥14 weeks and born after 1 October 2006 admitted with gastroenteritis. Total enrolled cohort=all children (cases and controls) for whom informed consent was obtained. ATP enrolled cohort=all valid enrolled cases and controls. ATP confirmed cohort=all valid cases confirmed by polymerase chain reaction with at least one valid control and their matched controls (used for analyses of vaccine effectiveness); (154 cases have 1 matched control, 61 cases have 2 matched controls)
None
Fig 2 Number of admissions attributable to gastroenteritis and rotavirus gastroenteritis (in according to protocol (ATP) enrolled cohort)
See this image and copyright information in PMC

Comment in

References

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