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. 2017 Nov 24;6(4):317-323.
doi: 10.1093/jpids/piw061.

Sustained High Effectiveness of RotaTeq on Hospitalizations Attributable to Rotavirus-Associated Gastroenteritis During 4 Years in Finland

Maria Hemming-Harlo  1 , Timo Vesikari  1 , Matti Uhari  2 , Marjo Renko  2 , Marjo Salminen  1 , Laurence Torcel-Pagnon  3 , Susanne Hartwig  3 , Francois Simondon  4 , Hélène Bricout  3
Affiliations

Sustained High Effectiveness of RotaTeq on Hospitalizations Attributable to Rotavirus-Associated Gastroenteritis During 4 Years in Finland

Maria Hemming-Harlo et al. J Pediatric Infect Dis Soc. .

Abstract

Key points: 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.

Keywords: RotaTeq; effectiveness; gastroenteritis; impact; rotavirus; vaccine.

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Figures

Figure 1.
Figure 1.
Wild-type rotavirus-associated acute gastroenteritis (wtRV-AGE) cases in this hospital-based prospective surveillance study, Finland, December 2009–August 2013.
Figure 2.
Figure 2.
Seasonal distribution of wild-type rotavirus acute gastroenteritis (wtRV-AGE) cases, Finland, 2009–2013.
Figure 3.
Figure 3.
Age distribution of wild-type rotavirus acute gastroenteritis (wtRV-AGE) cases according to study season, Finland, 2009–2013.
Figure 4.
Figure 4.
Number of wild-type rotavirus genotypes detected per study season, Finland, 2009–2013.
Figure 5.
Figure 5.
Annual incidence of rotavirus-associated acute gastroenteritis (RVGE) cases (continuous line) and all-cause acute gastroenteritis (All AGE) cases (dotted line) per 1000 children in the 6- to 47-month and 4- to 15-year age groups (according to hospital discharge records).
See this image and copyright information in PMC

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