Effectiveness of Pentavalent Rotavirus Vaccine in a Large Urban Population in the United States
Effectiveness of Pentavalent Rotavirus Vaccine in a Large Urban Population in the United States
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DOI：
10.1542/peds.2009-1021
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发表时间：
2010-02-01
期刊：
影响因子：
8
通讯作者：
Parashar, Umesh D.
中科院分区：
文献类型：
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作者：
Boom, Julie A.;Tate, Jacqueline E.;Parashar, Umesh D.
目的：我们的目标是评估完全（3剂）或部分（1-或2剂）的有效性五价轮状病毒疫苗（RV 5）对轮状病毒急性胃肠炎（AGE）在美国临床practice.METHODS：病例对照评价进行了2月至2008年6月在休斯顿，得克萨斯州的急诊科。通过对205例年龄在15天至23个月之间出现AGE的儿童粪便标本进行轮状病毒检测，确定了轮状病毒AGE病例（N = 90）。对照组包括轮状病毒阴性的AGE患者（N = 115），同时入选的急性呼吸道感染（ARI）患者（N = 228），以及从Houston-Harris County Immunization Registry（HHCIR）中抽取的10名年龄和邮政编码匹配的儿童，每个病例患者年龄>8个月。免疫接种数据来自父母记录、卫生保健提供者和/或HHCIR。疫苗有效性计算为1减去RV 5疫苗接种的病例患者与对照患者相比的优势，调整了就诊时的年龄和出生日期。（95%可信区间[CI]：70%-96%）和85%（95% CI：55%-95%），分别与轮状病毒阴性AGE和ARI对照患者。HHCIR中44%的病例患者（n = 40）的免疫数据可用;这些HHCIR对照患者的3剂疫苗有效性估计值为82%（95% CI：19%-96%）。一个完整的RV 5系列对需要住院治疗的严重轮状病毒疾病提供100%的保护（95% CI：71%-100%），对需要静脉补液的疾病提供96%的保护（95% CI：72%-99%）。使用轮状病毒阴性AGE和ARI对照组combined.CONCLUSIONS：在这种情况下，一个完整的系列RV 5对严重的轮状病毒AGE非常有效。部分免疫也提供了实质性保护。儿科2010; 125：e199-e207
OBJECTIVE: The goal was to assess the effectiveness of complete (3-dose) or partial (1- or 2-dose) immunization with pentavalent rotavirus vaccine (RV5) against rotavirus acute gastroenteritis (AGE) in US clinical practice.METHODS: A case-control evaluation was conducted in February through June 2008 at an emergency department in Houston, Texas. Case patients with rotavirus AGE (N = 90) were identified through testing for rotavirus in fecal specimens obtained from 205 children 15 days through 23 months of age presenting with AGE. Control groups included rotavirus-negative AGE patients (N = 115), concurrently enrolled patients with acute respiratory infection (ARI) (N = 228), and up to 10 age- and zip code-matched children sampled from the Houston-Harris County Immunization Registry (HHCIR) for each case patient >8 months of age. Immunization data were obtained from parent records, health care providers, and/or the HHCIR. Vaccine effectiveness was calculated as 1 minus odds of RV5 vaccination for case patients versus control patients, after adjustment for age at presentation and birth date.RESULTS: The vaccine effectiveness of a complete RV5 series was 89% (95% confidence interval [CI]: 70%-96%) and 85% (95% CI: 55%-95%) with rotavirus-negative AGE and ARI control patients, respectively. Immunization data were available for 44% of case patients (n = 40) from the HHCIR; the estimated 3- dose vaccine effectiveness with these HHCIR control patients was 82% (95% CI: 19%-96%). A complete RV5 series conferred 100% protection (95% CI: 71%-100%) against severe rotavirus disease requiring hospitalization and 96% protection (95% CI: 72%-99%) against disease requiring intravenous hydration. Vaccine effectiveness of 1 and 2 doses against hospitalization and emergency department visits was 69% (95% CI: 13%-89%) and 81% (95% CI: 13%-96%), respectively, using rotavirus-negative AGE and ARI control groups combined.CONCLUSIONS: In this setting, a complete series of RV5 was highly effective against severe rotavirus AGE. Partial immunization also conferred substantial protection. Pediatrics 2010; 125: e199-e207