Effectiveness of Pentavalent Rotavirus Vaccine Against Severe Disease
Effectiveness of Pentavalent Rotavirus Vaccine Against Severe Disease
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DOI：
10.1542/peds.2010-3722
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发表时间：
2011-08-01
期刊：
影响因子：
8
通讯作者：
Parashar, Umesh D.
中科院分区：
文献类型：
--
作者：
Staat, Mary Allen;Payne, Daniel C.;Parashar, Umesh D.
目的：探讨轮状病毒五价疫苗(RV5)完全接种和部分接种预防轮状病毒急性胃肠炎(AGE)住院和急诊的效果。方法：对2006年1月至2009年6月美国3个县住院和急诊轮状病毒感染(ARI)的年龄和急性呼吸道感染(ARI)进行积极、前瞻性的人群监测。根据出生日期和发病时间，将实验室确诊的轮状病毒年龄(病例)儿童与2组对照组进行匹配：轮状病毒阴性年龄儿童和ARI儿童。主要观察指标是接种完全(3剂)或部分(1或2剂)RV5疫苗的VE。结果：在入选的符合年龄的儿童中，18%的病例、54%的年龄对照组和54%的ARI对照组接受了1剂RV5。使用轮状病毒阴性年龄对照的1、2和3剂RV5对所有轮状病毒基因型的VE分别为74%(95%可信区间：37%-90%)、88%(95%可信区间：66%-96%)和87%(95%可信区间：71%-94%)，使用ARI对照的VE分别为73%(95%可信区间：43%-88%)、88%(95%可信区间：68%-95%)和85%(95%可信区间：72%-91%)，分别进行了分析。第一年和第二年的总体VE估计值与不同轮状病毒株引起的年龄相当。结论：RV5在预防严重轮状病毒疾病方面非常有效，即使在部分系列之后也是如此，保护作用持续到第二年。儿科2011；128：e267-e275
OBJECTIVE: To determine the vaccine effectiveness (VE) of complete and partial vaccination with the pentavalent rotavirus vaccine (RV5) in the prevention of rotavirus acute gastroenteritis (AGE) hospitalizations and emergency department visits during the first 3 rotavirus seasons after vaccine introduction.METHODS: Active, prospective population-based surveillance for AGE and acute respiratory infection (ARIs) in inpatient and emergency department settings provided subjects for a case-control evaluation of VE in 3 US counties from January 2006 through June 2009. Children with laboratory-confirmed rotavirus AGE (cases) were matched according to date of birth and onset of illness to 2 sets of controls: children with rotavirus-negative AGE and children with ARI. The main outcome measure was VE with complete (3 doses) or partial (1 or 2 doses) RV5 vaccination.RESULTS: Of age-eligible children enrolled, 18% of cases, 54% of AGE controls, and 54% of ARI controls received >= 1 dose of RV5. The VE of RV5 for 1, 2, and 3 doses against all rotavirus genotypes with the use of rotavirus-negative AGE controls was 74% (95% confidence interval [CI]: 37%-90%), 88% (95% CI: 66%-96%), and 87% (95% CI: 71%-94%), respectively, and with the use of ARI controls was 73% (95% CI: 43%88%), 88% (95% CI: 68%-95%), and 85% (95% CI: 72%-91%), respectively. The overall VE estimates were comparable during the first and second years of life and against AGE caused by different rotavirus strains.CONCLUSION: RV5 was highly effective in preventing severe rotavirus disease, even after a partial series, with protection persisting throughout the second year of life. Pediatrics 2011;128:e267-e275