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. 2024 Jan-Dec;23(1):789-795.
doi: 10.1080/14760584.2024.2395534. Epub 2024 Sep 1.

Indirect protection from rotavirus vaccines: a systematic review

Tyler Chavers  1 , Jordan Cates  1 , Eleanor Burnett  1 , Umesh D Parashar  1 , Jacqueline E Tate  1
Affiliations

Indirect protection from rotavirus vaccines: a systematic review

Tyler Chavers et al. Expert Rev Vaccines. 2024 Jan-Dec.

Abstract

Introduction: Rotavirus vaccines may provide indirect protection by reducing transmission in the population and thus reducing disease burden.

Methods: This systematic review summarizes estimates of indirect protection from rotavirus vaccines and the methods used to obtain these estimates.

Results: We identified 71 studies published between 2009 and 2022 that provided 399 estimates of indirect protection from rotavirus vaccine. Most estimates (73%) evaluated hospitalizations due to rotavirus gastroenteritis as the outcome and unvaccinated children <5 years old as the agegroup (64%), but there was considerable variability in methods to evaluate indirect protection. For hospitalizations due to rotavirus gastroenteritis among unvaccinated children <5 years old, the median incidence rate ratio was 0.60 (IQR: 0.40-0.87, n = 110 estimates), the median relative percent change in percent positivity was 25% (IQR: 13-44%, n = 49 estimates), and the median relative percent change in absolute number of rotavirus positive tests or rotavirus-specific International Classification of Diseases codes was 42% (IQR: 16-66%, n = 40 estimates).

Conclusions: These findings broadly suggest rotavirus vaccines provide some indirect protection. There is a need to standardize measurement of indirect rotavirus vaccine protection, particularly using consistent outcomes and metrics, and stratifying results by standardized age groups and years since vaccine introduction.

Keywords: Herd protection; indirect protection; indirect vaccine protection; rotavirus; vaccine.

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Figures

Figure 1.
Figure 1.
Article selection and breakdown of studies published between 2009 and 2022 identified in a systematic review of indirect protection provided by rotavirus vaccines.
Figure 2.
Figure 2.
Distributions of three metrics of indirect protection of rotavirus vaccine: incidence rate ratios of rotavirus hospitalization (N=110), relative percent change in the percent positivity of rotavirus among hospitalizations (N=49), and relative percent change in the absolute number of rotavirus positive tests or ICD codes (N=40) among hospitalized children less than 5 years of age from studies published between 2009 and 2022 identified in a systematic review of indirect protection provided by rotavirus vaccines. IQR=interquartile range
Figure 3.
Figure 3.
Distributions of indirect protection incidence rate ratios of rotavirus hospitalization among unvaccinated children <5 years of age stratified by country-level child mortality strata from studies published between 2009 and 2022 identified in a systematic review of indirect protection provided by rotavirus vaccines. IQR=Interquartile range
See this image and copyright information in PMC

References

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